Geddy P M, Gray S, Reid W A
Department of Clinical Medicine, University of Leeds, UK.
Histopathology. 1993 Apr;22(4):387-90. doi: 10.1111/j.1365-2559.1993.tb00141.x.
Angioleiomyoma is frequently painful and the cause of the pain is unknown. The purpose of this study was to compare the mast cell population and innervation of painful and painless angioleiomyomas. Twenty-four cases of angioleiomyoma were examined; 16 painful and 8 painless cases. Pinacyanol erythrosinate and antibodies to protein gene product (PGP) 9.5 were used to demonstrate mast cells and nerves respectively. PGP 9.5-immunoreactive nerve fibres were found in most of the painful (13/16 cases) and painless lesions (5/8). Mast cells were not seen in half of the painful lesions but were seen in most of the painless lesions (7/8). The median mast cell density was 1.1 cells/mm2 for the painful lesions and 21.9 cells/mm2 for the painless lesions (P = 0.048, Mann-Whitney test). The lower mast cell density in the painful lesions may reflect increased mast cell degranulation. It is proposed that neural and vascular events, similar to those occurring in the triple response to mild cutaneous injury, may produce pain in angioleiomyoma and other painful skin tumours.
血管平滑肌瘤常伴有疼痛，但其疼痛原因尚不清楚。本研究旨在比较疼痛性和无痛性血管平滑肌瘤中的肥大细胞数量及神经分布情况。对24例血管平滑肌瘤进行了检查，其中16例有疼痛症状，8例无疼痛症状。分别用赤藓红哌啶醇和蛋白基因产物（PGP）9.5抗体来显示肥大细胞和神经。在大多数有疼痛症状的病变（13/16例）和无痛性病变（5/8例）中均发现了PGP 9.5免疫反应性神经纤维。半数有疼痛症状的病变中未见到肥大细胞，而在大多数无痛性病变（7/8例）中可见到肥大细胞。有疼痛症状病变的肥大细胞密度中位数为1.1个细胞/mm²，无痛性病变为21.9个细胞/mm²（曼-惠特尼检验，P = 0.048）。有疼痛症状病变中较低的肥大细胞密度可能反映了肥大细胞脱颗粒增加。有人提出，类似于轻度皮肤损伤三联反应中发生的神经和血管事件，可能会在血管平滑肌瘤和其他疼痛性皮肤肿瘤中产生疼痛。
