Santa Cruz D J, Martin S A
Am J Clin Pathol. 1979 Feb;71(2):224-8. doi: 10.1093/ajcp/71.2.224.
Two cases of verruciform xanthoma of the vulva are described. This rare lesion, previously reported to occur only in the oral cavity, is characterized by a verrucous epithelial proliferation accompanied by xanthoma cells distributed exclusively in the papillary dermis. The histologic features of the lesion are diagnostic and include (1) regular acanthosis in which the rete pegs extend to a uniform level into the dermis; (2) hyperkeratosis with parakeratosis often extending deep into the rete pegs and manifesting a massive neutrophilic infiltrate; (3) hyalinization of the collagen and infiltrates of xanthoma cells that are restricted to the papillary dermis between the rete pegs. Additionally, a lichenoid inflammatory infiltrate is seen at the periphery of the verrucous lesions, and in one case this has the pattern of classic lichen sclerosus. Verruciform xanthoma must be differentiated from verruca vulgaris, condyloma acuminatum, granular cell tumor with pseudoepitheliomatous hyperplasia, and verrucous carcinoma.
本文描述了两例外阴疣状黄色瘤。这种罕见的病变此前报道仅发生于口腔，其特征为疣状上皮增生，伴有仅分布于乳头真皮层的黄色瘤细胞。该病变的组织学特征具有诊断意义，包括：（1）规则性棘皮症，其中 rete 钉突延伸至真皮层的同一水平；（2）角化过度伴角化不全，常深入 rete 钉突并表现为大量中性粒细胞浸润；（3）胶原的玻璃样变以及黄色瘤细胞浸润，局限于 rete 钉突之间的乳头真皮层。此外，在疣状病变周边可见苔藓样炎性浸润，在其中一例中具有经典硬化性苔藓的模式。疣状黄色瘤必须与寻常疣、尖锐湿疣、伴有假上皮瘤样增生的颗粒细胞瘤以及疣状癌相鉴别。
