Winkelmann R K, Dahl P R, Perniciaro C
Mayo Clinic Scottsdale, Ariz, USA.
J Am Acad Dermatol. 1998 Jun;38(6 Pt 1):967-70. doi: 10.1016/s0190-9622(98)70161-6.
Necrobiotic xanthogranuloma (NXG) with paraproteinemia is a distinctive palisading granuloma of the skin. Extracutaneous lesions are rarely present.
The purpose of this study was to confirm the presence and significance of giant cell asteroid bodies and other cytoplasmic inclusions in NXG with paraproteinemia.
Skin biopsy specimens from 24 patients with NXG with paraproteinemia were reviewed; autopsy and lung biopsy specimens from two patients were stained for iron, calcium, and polysaccharide.
Giant cell asteroid bodies were observed in skin biopsy specimens of 8 (33%) of the 24 patients. In addition, large acidophilic polygonal cytoplasmic inclusions were observed in myocardial tissue of one of the autopsy cases. Iron and calcium were not found.
Asteroid bodies and other inclusions can be present in the giant cells of NXG with paraproteinemia. They are as frequent as, or more frequent than, in other granulomatous diseases and should be considered in the diagnosis of NXG with paraproteinemia.
伴有副蛋白血症的坏死性黄色肉芽肿（NXG）是一种独特的皮肤栅栏状肉芽肿。很少出现皮肤外病变。
本研究的目的是证实伴有副蛋白血症的NXG中巨细胞星状体和其他细胞质内含物的存在及其意义。
回顾了24例伴有副蛋白血症的NXG患者的皮肤活检标本；对2例患者的尸检和肺活检标本进行铁、钙和多糖染色。
24例患者中有8例（33%）的皮肤活检标本中观察到巨细胞星状体。此外，在其中1例尸检病例的心肌组织中观察到大型嗜酸性多边形细胞质内含物。未发现铁和钙。
伴有副蛋白血症的NXG的巨细胞中可出现星状体和其他内含物。它们在NXG中与其他肉芽肿性疾病中出现的频率相同或更高，在伴有副蛋白血症的NXG诊断中应予以考虑。
