Arnold M L, Anton-Lamprecht I
Department of Dermatology, Ruprecht-Karls University, Heidelberg, Germany.
Am J Dermatopathol. 1993 Dec;15(6):581-6. doi: 10.1097/00000372-199312000-00013.
A 67-year-old woman had multiple, pinhead-sized, yellowish papules localized to her face, scalp, and neck. A previously diagnosed T-cell lymphoma of low malignancy had been treated with cytostatic drugs. Ultrastructurally the dermal infiltrate consisted predominantly of histiocytic cells in various degrees of differentiation. The cells revealed signs of high metabolic activity and contained well-developed mitochondria, rough endoplasmic reticulum, and lysosomes. Groups of worm-like bodies (comma-shape bodies) and great numbers of coated vesicles in various sizes could be regularly found. Microvillous cell processes formed close interdigitations, and desmosome-like structures occurred between adjacent cell membranes. Lipid storage was present in the form of neutral lipid vacuoles, cholesterol clefts, and myelin-like arrangements of phospholipid membranes. Some multinucleated histiocytic cells, mast cells, lymphocytes, and eosinophilic granulocytes were encountered in the infiltrate. No dermal Langerhans' cells with their characteristic granules were present. Similarities to and differences from benign cephalic histiocytosis, generalized eruptive histiocytoma, and other xanthomatous disorders are discussed.
一名67岁女性面部、头皮和颈部出现多个针头大小的黄色丘疹。该患者先前被诊断为低恶性度T细胞淋巴瘤，已接受细胞抑制药物治疗。超微结构显示，真皮浸润主要由不同分化程度的组织细胞组成。这些细胞显示出高代谢活性的迹象，含有发育良好的线粒体、粗面内质网和溶酶体。可经常发现成组的蠕虫样体（逗号形体）和大量大小不一的有被小泡。微绒毛状细胞突起形成紧密的指状交叉，相邻细胞膜之间出现桥粒样结构。脂质以中性脂质空泡、胆固醇裂隙和磷脂膜的髓鞘样排列的形式储存。浸润中可见一些多核组织细胞、肥大细胞、淋巴细胞和嗜酸性粒细胞。未发现具有特征性颗粒的真皮朗格汉斯细胞。讨论了与良性头部组织细胞增多症、泛发性发疹性组织细胞瘤和其他黄瘤病的异同。
