Fariña M C, Requena L, Dómine M, Soriano M L, Estevez L, Barat A
Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain.
J Cutan Pathol. 1998 Nov;25(10):559-62. doi: 10.1111/j.1600-0560.1998.tb01741.x.
Granulocyte colony-stimulating factor (G-CSF) is a hematopoietic growth factor (HGF) with many applications in cancer therapy. The most important applications are reduction in the incidence of febrile neutropenia, acceleration of neutrophil recovery after chemotherapy or bone marrow transplantation, and mobilization of progenitor cells. Many cutaneous adverse reactions associated with HGF have been reported in recent years, including injection site reactions, pyoderma gangrenosum, Sweet's syndrome, cutaneous leucocytoclastic vasculitis, and widespread folliculitis. The presence of large histiocytes on the dermis between collagen bundles has been proposed as a characteristic histopathologic finding in cutaneous eruptions secondary to granulocyte colony-stimulating factor and granulocyte-macrophage colony-stimulating factor. We report on a patient with a high-risk ductal infiltrating carcinoma of the breast who received high-dose chemotherapy (HDC) with peripheral blood progenitor cell (PBPC) rescue. The patient received G-CSF after PBPC for a faster granulocyte recovery. She developed a cutaneous eruption located on back, buttocks, axillae, groin and sites where electrocardiography electrodes had been placed. From the histopathological point of view, the eruption was characterized by the presence of numerous large, atypical histiocytes in the dermis with several mitotic figures, mimicking involvement of the dermis by a malignant process.
粒细胞集落刺激因子（G-CSF）是一种造血生长因子（HGF），在癌症治疗中有多种应用。最重要的应用包括降低发热性中性粒细胞减少症的发生率、加速化疗或骨髓移植后中性粒细胞的恢复以及动员祖细胞。近年来，已报道了许多与造血生长因子相关的皮肤不良反应，包括注射部位反应、坏疽性脓皮病、Sweet综合征、皮肤白细胞破碎性血管炎和广泛的毛囊炎。真皮中胶原束之间存在大量组织细胞被认为是粒细胞集落刺激因子和粒细胞-巨噬细胞集落刺激因子继发皮肤疹的特征性组织病理学表现。我们报告了一名患有高危乳腺导管浸润癌的患者，该患者接受了高剂量化疗（HDC）并进行外周血祖细胞（PBPC）救援。患者在PBPC后接受G-CSF以更快地恢复粒细胞。她在背部、臀部、腋窝、腹股沟以及放置心电图电极的部位出现了皮肤疹。从组织病理学角度来看，皮疹的特征是真皮中存在大量大型非典型组织细胞，并伴有多个有丝分裂象，类似于恶性过程累及真皮。
