毛發(fā)上皮瘤的臨床病理分析
發(fā)布時間：2018-08-04 15:38
【摘要】：目的：探討毛發(fā)上皮瘤臨床及病理學改變的特點,為診治毛發(fā)上皮瘤提供科學的依據(jù)。 方法：收集2000-2010年經(jīng)我院確診的18例毛發(fā)上皮瘤患者臨床病例資料和病理學標本,其中男性7例,女性11例,發(fā)病年齡15歲-58歲,病程3個月-15年。采用4%甲醛溶液將所有病理標本固定,常規(guī)經(jīng)過組織脫水后石蠟包埋、切片及HE染色,綜合分析病理學改變及臨床的特點。 結(jié)果；18例毛發(fā)上皮瘤患者中,男性7例(占38.9%),女性11例(占61.1%),平均發(fā)病年齡37.2歲。本病主要表現(xiàn)為丘疹或結(jié)節(jié),大部分患者沒有自覺癥狀。10例皮損多發(fā)者,皮疹主要位于鼻唇溝兩側(cè),對稱分布,少數(shù)累及頸部或下眼瞼；8例皮損單發(fā)者,分別分布在鼻背或鼻翼。通常幼年或青年時期為多發(fā)性毛發(fā)上皮瘤發(fā)病期,皮疹出現(xiàn)后并逐漸加重,呈膚色,淡黃色的半球形實性丘疹或小結(jié)節(jié),直徑一般在0.2-0.5cm。組織病理學改變主要是基底細胞樣細胞增生,向毛囊及皮脂腺導管分化,可見大量基底樣細胞成團分布,邊緣基底樣細胞成柵欄樣排列,繞以明顯的纖維母細胞及纖維性基質(zhì),部分切片內(nèi)可見裂隙出現(xiàn)于結(jié)締組織之間,有許多角囊腫和毛乳頭樣結(jié)構(gòu),有時在角化組織內(nèi)可發(fā)現(xiàn)鈣化。臨床可誤診為黑痣、汗管瘤、基底細胞癌等。本研究收集的8例單發(fā)性毛發(fā)上皮瘤病例,均經(jīng)過美容外科手術(shù)切除,經(jīng)1年隨訪,7例無復發(fā),1例繼發(fā)鱗癌；10例多發(fā)性毛發(fā)上皮瘤采用超脈沖二氧化碳激光治療,病例隨訪1年,無瘢痕、復發(fā)及惡變傾向。 結(jié)論：①單發(fā)性毛發(fā)上皮瘤一般為直徑0.5cm孤立結(jié)節(jié),單靠臨床表現(xiàn)很難確診;多發(fā)性毛發(fā)上皮瘤多與遺傳因素有關(guān),多好發(fā)于鼻唇溝兩側(cè)、大小不等丘疹結(jié)節(jié),直徑0.2-0.5cm,必須依靠家族史及組織病理學檢查確診。②對于毛發(fā)上皮瘤患者可采用激光、手術(shù)等治療手段。
[Abstract]:Objective: To investigate the clinical and pathological features of hair follicle epithelioma, and to provide scientific evidence for the diagnosis and treatment of hair epithelial tumor.
Methods: the clinical data and pathological specimens of 18 cases of hair epithelioma confirmed by our hospital for 2000-2010 years were collected, including 7 males and 11 females. The age of onset was 15 years old -58 years, and the course of disease was 3 months -15. All pathological specimens were fixed with 4% Formaldehyde Solution, and the paraffin embedded after dehydration, slice and HE staining, comprehensive analysis. Pathological changes and clinical characteristics.
Results: among the 18 cases of hair epithelioma, 7 cases (38.9%) were male (38.9%), 11 cases (61.1%), and the average age was 37.2 years old. The main manifestations were papules or nodules. Most patients had no conscious symptoms,.10 cases had multiple lesions. The rash was mainly located on both sides of the nasolabial groove, symmetrical distribution, a few of the neck or lower eyelids, and 8 cases with single lesions. In the onset of multiple hair epithelioma, usually in young or young age, after the occurrence of a rash and gradually aggravated, a skin color, a pale yellow hemispherical papule or small nodule, and the diameter of the 0.2-0.5cm. histologically is usually characterized by basal cell like cell proliferation and differentiation into the hair follicle and the sebaceous gland ducts. It can be seen that a large number of basal like cells are distributed in groups. The marginal basal like cells are arranged in a palisade like arrangement, around the obvious fibroblast and fibrous matrix, and the cracks appear in the connective tissue, with many angular cysts and hair papilla like structures. Sometimes calcification can be found in the keratinized group. Clinical misdiagnosis can be misdiagnosed as a black nevus and a sweat tube tumor. 8 cases of single hair epithelioma collected in this study were excised by cosmetic surgery and were followed up for 1 years, 7 cases had no recurrence, 1 cases of secondary squamous cell carcinoma, and 10 cases of multiple hair epithelioma were treated with hyperpulse carbon dioxide laser. The cases were followed up for 1 years, no scar, recurrence and malignant tendency.
Conclusion: (1) the solitary hair epithelioma is usually 0.5cm solitary nodule in diameter, which is difficult to diagnose by clinical manifestation. Multiple hair epithelioma is mostly associated with hereditary factors. It is more likely to occur on both sides of the nasolabial groove, the size of the papular nodules, and the diameter of 0.2-0.5cm. It must be confirmed by family history and histopathological examination. They can be treated with laser and surgery.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R739.5
[Abstract]:Objective: To investigate the clinical and pathological features of hair follicle epithelioma, and to provide scientific evidence for the diagnosis and treatment of hair epithelial tumor.
Methods: the clinical data and pathological specimens of 18 cases of hair epithelioma confirmed by our hospital for 2000-2010 years were collected, including 7 males and 11 females. The age of onset was 15 years old -58 years, and the course of disease was 3 months -15. All pathological specimens were fixed with 4% Formaldehyde Solution, and the paraffin embedded after dehydration, slice and HE staining, comprehensive analysis. Pathological changes and clinical characteristics.
Results: among the 18 cases of hair epithelioma, 7 cases (38.9%) were male (38.9%), 11 cases (61.1%), and the average age was 37.2 years old. The main manifestations were papules or nodules. Most patients had no conscious symptoms,.10 cases had multiple lesions. The rash was mainly located on both sides of the nasolabial groove, symmetrical distribution, a few of the neck or lower eyelids, and 8 cases with single lesions. In the onset of multiple hair epithelioma, usually in young or young age, after the occurrence of a rash and gradually aggravated, a skin color, a pale yellow hemispherical papule or small nodule, and the diameter of the 0.2-0.5cm. histologically is usually characterized by basal cell like cell proliferation and differentiation into the hair follicle and the sebaceous gland ducts. It can be seen that a large number of basal like cells are distributed in groups. The marginal basal like cells are arranged in a palisade like arrangement, around the obvious fibroblast and fibrous matrix, and the cracks appear in the connective tissue, with many angular cysts and hair papilla like structures. Sometimes calcification can be found in the keratinized group. Clinical misdiagnosis can be misdiagnosed as a black nevus and a sweat tube tumor. 8 cases of single hair epithelioma collected in this study were excised by cosmetic surgery and were followed up for 1 years, 7 cases had no recurrence, 1 cases of secondary squamous cell carcinoma, and 10 cases of multiple hair epithelioma were treated with hyperpulse carbon dioxide laser. The cases were followed up for 1 years, no scar, recurrence and malignant tendency.
Conclusion: (1) the solitary hair epithelioma is usually 0.5cm solitary nodule in diameter, which is difficult to diagnose by clinical manifestation. Multiple hair epithelioma is mostly associated with hereditary factors. It is more likely to occur on both sides of the nasolabial groove, the size of the papular nodules, and the diameter of 0.2-0.5cm. It must be confirmed by family history and histopathological examination. They can be treated with laser and surgery.
【學位授予單位】：延邊大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R739.5
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