Walsh N M, Murray S, D'Intino Y
Department of Pathology, Victoria General Hospital, Nova Scotia, Canada.
J Cutan Pathol. 1994 Aug;21(4):350-5. doi: 10.1111/j.1600-0560.1994.tb00711.x.
The microscopic manifestations of eruptive xanthomata are variable and although they are most frequently characterized by aggregations of foamy macrophages in the dermis, they can, on occasion, simulate granuloma annulare. We have recently encountered a further unusual histopathological variant of eruptive xanthomata in 3 skin biopsies from 2 patients with hypertriglyceridemia. The lesions had a granuloma annulare-like pattern at low magnification, the exceptional feature being their content of polarizable, needle-shaped crystals. These bore a strong resemblance to monosodium urate monohydrate and displayed negative birefringence under polarized light. In the case of each patient, an initial pathological diagnosis of gout was rendered, and the true nature of the lesions came to light only after clinicopathologic correlation. While it is clear that the chemical composition of these crystals requires further study, recognition of this microscopic variant of eruptive xanthomata should help to reduce errors in diagnosis.
发疹性黄瘤的微观表现多样，虽然其最常见的特征是真皮内泡沫状巨噬细胞聚集，但有时可类似环状肉芽肿。我们最近在2例高甘油三酯血症患者的3次皮肤活检中遇到了发疹性黄瘤一种不寻常的组织病理学变异型。病变在低倍镜下呈环状肉芽肿样模式，其特殊之处在于含有可偏振的针状晶体。这些晶体与一水合尿酸钠极为相似，在偏振光下呈负双折射。在每例患者中，最初的病理诊断均为痛风，仅在临床病理相关分析后才明确病变的真实性质。虽然这些晶体的化学成分显然需要进一步研究，但认识到这种发疹性黄瘤的微观变异型应有助于减少诊断错误。
