Wilk M, Schmoeckel C
Department of Dermatology, University of Bonn, Germany.
J Cutan Pathol. 1994 Oct;21(5):446-52. doi: 10.1111/j.1600-0560.1994.tb00287.x.
The histogenesis of cutaneous focal mucinosis (CFM) is controversial. Eleven cases of CFM (5F, 6M; mean age 51 years) from our routine files between 1986 and the present time have, therefore, been examined histopathologically and immunohistochemically. Histology revealed an increased number of fibroblast-like cells in early lesions, whereas they were diminished or predominantly at the margin in advanced ones. The myxomatous areas showed slight to absent reticulum formation. Similarly, elastic fibers were almost absent, and collagen fibers were fragmented and replaced by variable amounts of mucin. One specimen revealed an epithelial component within the lesion reminiscent of a poorly induced trichofolliculoma. Immunohistochemically, vimentin was consistently present and correlated with the number of fibroblast-like cells. A few (< 5%) CD34+ dermal dendritic cells (DDs) were focally seen within CFM. In contrast, FXIIIa+ DDs accounted for up to 30%. Fibroblast-like cells were negative for S-100 protein, Leu7, desmin and alpha-SMA. The epithelial component within one of our specimens seems to have been induced by CFM and is a feature also seen in (angio)-myxomas. CFM appears to be a mesenchymally derived lesion composed predominantly of fibroblasts. DDs do not form the major cell component but rather seem passively incorporated.
皮肤局灶性黏液瘤（CFM）的组织发生存在争议。因此，对1986年至目前我们常规病例档案中的11例CFM（5例女性，6例男性；平均年龄51岁）进行了组织病理学和免疫组织化学检查。组织学显示，早期病变中成纤维细胞样细胞数量增加，而在晚期病变中数量减少或主要位于边缘。黏液瘤区域网状纤维形成轻微或缺失。同样，弹性纤维几乎缺失，胶原纤维断裂并被不同量的黏液替代。一个标本显示病变内有上皮成分，类似诱导不良的毛囊瘤。免疫组织化学显示，波形蛋白始终存在，且与成纤维细胞样细胞数量相关。在CFM内局部可见少数（<5%）CD34+真皮树突状细胞（DDs）。相比之下，FXIIIa+ DDs占比高达30%。成纤维细胞样细胞对S-100蛋白、Leu7、结蛋白和α-SMA均呈阴性。我们的一个标本中的上皮成分似乎是由CFM诱导产生的，这也是（血管）黏液瘤中可见的特征。CFM似乎是一种主要由成纤维细胞组成的间充质来源病变。DDs并非主要细胞成分，而是似乎被被动纳入。
