Beham A, Fletcher C D, Feichtinger J, Zelger B, Schmid C, Humer U
Institute of Pathology, University of Graz Medical School, Austria.
Virchows Arch A Pathol Anat Histopathol. 1993;423(4):315-8. doi: 10.1007/BF01606897.
We present two female patients, aged 15 and 45 years, with synovial metaplasia of the skin. Both lesions, localized in the knee and hand respectively, arose after preceding local trauma. Case 1 had intradermal irregular cystic spaces in the adjacent myxoid stroma of which large polygonal eosinophilic cells were found. In contrast, case 2 was characterized by a longitudinal space within the lower dermis and subcutis which was lined by a membrane similar to hyperplastic synovium. The cells of the membrane showed an eosinophilic spindle shaped cytoplasm with processes towards the lumen. In both cases the eosinophilic cells, strongly suggestive of fibroblasts, showed staining for vimentin only, whereas no reactivity could be obtained with antibodies to actin, desmin, S-100 protein, Factor VIII related antigen, cytokeratin, epithelial membrane antigen, carcinoembryonic antigen and CD 68. The absence of CD 68 positivity differs from that seen in normal and hyperplastic synovium. Delayed wound healing around a nidus seems the most likely cause of the change.
我们报告了两名分别为15岁和45岁的女性皮肤滑膜化生患者。这两个病变分别位于膝盖和手部，均在先前局部创伤后出现。病例1在相邻的黏液样间质中有真皮内不规则囊性间隙，其中发现了大的多边形嗜酸性细胞。相比之下，病例2的特征是在真皮下部和皮下组织中有一个纵向间隙，其内衬有类似于增生性滑膜的膜。该膜的细胞显示出嗜酸性梭形细胞质，并向管腔伸出突起。在这两个病例中，强烈提示为成纤维细胞的嗜酸性细胞仅显示波形蛋白染色，而针对肌动蛋白、结蛋白、S-100蛋白、因子VIII相关抗原、细胞角蛋白、上皮膜抗原、癌胚抗原和CD 68的抗体均未显示反应性。CD 68阳性的缺失与正常和增生性滑膜中所见不同。病灶周围伤口愈合延迟似乎是这种变化最可能的原因。
