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[皮肤和软组织的血管肿瘤。新特征化实体和变体概述]

[Vascular tumors of the skin and soft tissue. Overview of newly characterized entities and variants].

作者信息

Mentzel T, Calonje E, Fletcher C D

机构信息

Institut für Pathologie der Friedrich-Schiller-Universität, Jena.

出版信息

Pathologe. 1994 Oct;15(5):259-70. doi: 10.1007/s002920050053.

Abstract

This review summarizes vascular tumours of skin and soft tissues that have been characterised in recent years. Although most of them are very rare, knowledge about their reproducible clinicopathological features is important to avoid diagnostic pitfalls. These lesions include: bacillary angiomatosis, a vasoproliferative, pseudoneoplastic infection of immunocompromised patients caused by Rochalimaea henselae; tufted angioma, a variant of lobular capillary haemangioma characterised by a "cannon-ball" distribution of multiple lobules composed of packed capillaries and pericytes; microvenular haemangioma, a cutaneous haemangioma composed of thin-walled and irregularly branching blood vessels which dissect dermal collagen; sinusoidal haemangioma, a distinctive variant of cavernous haemangioma which may be located in the subcutaneous breast tissue and then may be confused with well-differentiated angiosarcoma; "hobnail haemangioma" (targetoid haemosiderotic haemangioma), a benign vascular tumour with a distinctive clinical targetoid appearance and a hobnail cytomorphology of the prominent endothelial tumour cells; retiform haemangioendothelioma, a very recently characterised low-grade angiosarcoma occurring most commonly in the extremities of adolescents which is characterised by arborising blood vessels arranged in a retiform pattern and lined by hobnail-like prominent endothelial cells; Kaposi-like infantile haemangioendothelioma, a borderline malignant tumour of infants mimicking Kaposi's sarcoma histologically; epithelioid angiosarcoma, a highly aggressive tumour in the spectrum of epithelioid vascular lesions which stains positively for endothelial and epithelial immunohistological markers; benign lymph-angioendothelioma (progressive lymphangioma), a benign, slowly growing macule or plaque which has to be distinguished from well-differentiated angiosarcoma and Kaposi's sarcoma; and lymphangiomatosis of the limbs, a poorly recognised angiomatosis occurring in young patients and limited mainly to the limbs with a favourable prognosis.

摘要

本综述总结了近年来已明确特征的皮肤和软组织血管肿瘤。尽管其中大多数非常罕见,但了解其可重复的临床病理特征对于避免诊断陷阱很重要。这些病变包括:杆菌性血管瘤,一种由汉赛巴尔通体引起的免疫功能低下患者的血管增生性假肿瘤性感染;簇状血管瘤,小叶状毛细血管瘤的一种变体,其特征是多个小叶呈“炮弹”样分布,由密集的毛细血管和周细胞组成;微静脉血管瘤,一种由薄壁且不规则分支的血管构成的皮肤血管瘤,这些血管分割真皮胶原;窦状血管瘤,海绵状血管瘤的一种独特变体,可位于乳腺皮下组织,可能与高分化血管肉瘤混淆;“鞋钉状血管瘤”(靶样含铁血黄素性血管瘤),一种具有独特临床靶样外观和突出内皮肿瘤细胞鞋钉样细胞形态的良性血管肿瘤;网状血管内皮瘤,一种最近才明确特征的低级别血管肉瘤,最常见于青少年四肢,其特征是呈网状排列的树枝状血管,内衬鞋钉样突出内皮细胞;卡波西样婴儿血管内皮瘤,一种组织学上类似卡波西肉瘤的婴儿交界性恶性肿瘤;上皮样血管肉瘤,上皮样血管病变谱中的一种高度侵袭性肿瘤,内皮和上皮免疫组化标记物染色呈阳性;良性淋巴管内皮瘤(进行性淋巴管瘤),一种良性、生长缓慢的斑疹或斑块,必须与高分化血管肉瘤和卡波西肉瘤相鉴别;以及肢体淋巴管瘤病,一种认识不足的血管瘤病,发生于年轻患者,主要局限于肢体,预后良好。

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