Morsani College of Medicine, University of South Florida, Tampa, Florida, USA.
Department of Dermatology and Cutaneous Surgery, University of South Florida, Tampa, Florida, USA.
J Cutan Pathol. 2021 Jun;48(6):781-784. doi: 10.1111/cup.13966. Epub 2021 Feb 11.
Hydrophilic polymer-coated devices have been increasingly utilized for various endovascular procedures, however not been without adverse effects. We report two cases of subacute cutaneous lesions on the neck encountered in our dermatology clinic. Histopathologic findings were significant for a nodular aggregate of epithelioid histiocytes and lymphocytes with numerous foreign body giant cells in the dermis. The granulomatous infiltrate was associated with an amorphous basophilic non-polarizable material. Further chart review reveals both patients receiving a central venous procedure in the past, thus attributing the hydrophilic polymers as the likely source of the foreign material found at the insertion site. Our cases contrast to the more commonly reported distal embolization by these hydrophilic polymer layers. We suspect the incidence of retained hydrophilic polymer at the site of prior endovascular procedures may be underreported in the literature with the more inconspicuous presentations. Therefore, retained foreign material should be considered by both treating physicians and dermatopathologists in presenting cases of lesions that occur at common sites of endovascular procedures.
亲水聚合物涂层装置已越来越多地用于各种血管内程序，但并非没有不良影响。我们报告了在皮肤科诊所遇到的颈部亚急性皮肤损伤的两个病例。组织病理学发现真皮中有结节状聚集的上皮样组织细胞和淋巴细胞，并有许多异物巨细胞。肉芽肿浸润与无定形嗜碱性非极化物质有关。进一步的图表审查显示，两名患者均在过去接受过中心静脉程序，因此将亲水性聚合物归因于在插入部位发现的异物的可能来源。我们的病例与更常见的报道相反，即这些亲水聚合物层更远处的栓塞。我们怀疑在文献中，以前的血管内程序部位残留的亲水性聚合物的发生率可能被低估了，因为这些表现不太明显。因此，在出现血管内程序常见部位的病变时，治疗医生和皮肤病理学家都应考虑到残留的异物。
