中华皮肤科杂志 ›› 2020, Vol. 53 ›› Issue (2): 133-135.doi: 10.35541/cjd.20190287

• 研究报道 • 上一篇    下一篇

毛发上皮瘤的皮肤影像学特征分析

姜倩    陈红英    马玲    黄萌    夏云    陈金波    陈柳青   

  1. 武汉市第一医院皮肤科  430022
  • 收稿日期:2019-01-31 修回日期:2019-08-22 发布日期:2020-02-01
  • 通讯作者: 陈柳青；陈金波 E-mail:chlq35@126.com；chen999jb@163.com
  • 基金资助:
    武汉市2016年度“黄鹤英才”（医疗卫生）计划项目

Analysis of imaging characteristics of trichoepithelioma

Jiang Qian, Chen Hongying, Ma Ling, Huang Meng, Xia Yun, Chen Jinbo, Chen Liuqing   

  1. Department of Dermatology, Wuhan No.1 Hospital, Wuhan 430022, China
  • Received:2019-01-31 Revised:2019-08-22 Published:2020-02-01
  • Contact: Chen Liuqing; Chen Jinbo E-mail:chlq35@126.com；chen999jb@163.com
  • Supported by:
    2016 Wuhan Yellow Crane Talents （Health Care） Program

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摘要： 【摘要】 目的 比较毛发上皮瘤的反射式共聚焦显微镜（RCM）和皮肤镜特征与组织病理学特征。方法 2017年1月至2018年12月于武汉市第一医院皮肤科门诊收集经组织病理学确诊的毛发上皮瘤患者23例，采集RCM、皮肤镜图像，对比其与组织病理学特征的一致性。结果 23例中，男5例，女18例，年龄（39.5 ± 22.1）岁。组织病理特征：肿瘤界限清楚，周围有丰富的纤维基质；肿瘤团块为多数基底样细胞集合或相互交织的基底样细胞索，周边细胞呈栅栏样排列；肿瘤细胞不同程度地向毛乳头分化；可见不等数量的角囊肿。RCM特征：23例患者中8例可见真表皮交界处芽蕾样下延的条索状细胞，有栅栏样排列趋势；18例可见真皮层散在分布结节状似有分叶的瘤团，与周围组织无收缩间隙，呈扩大的低回声结构；16例瘤团周围有中高折光的无定形基质包绕；16例患者可见特征性的疑似原始分化毛乳头结构；20例可见清晰的角囊肿。皮肤镜特征：20例可清晰观察到珍珠白色、均质状结构，10例线状毛细血管扩张。结论 毛发上皮瘤的RCM特征与组织病理具有较高一致性，可作为辅助诊断及鉴别诊断的有效方法。

关键词: 显微镜检查, 共焦； 皮肤镜检查； 毛发上皮瘤； 组织病理

Abstract: 【Abstract】 Objective To investigate dermoscopic, reflectance confocal microscopic （RCM） and histopathological features of trichoepithelioma. Methods A total of 23 outpatients with histopathologically confirmed trichoepithelioma were enrolled from Department of Dermatology, Wuhan No.1 Hospital between January 2017 and December 2018. Dermoscopic and RCM images were collected, and the consistency was analyzed between dermoscopic or RCM features and histopathological features. Results Among the 23 patients, 5 were male, and 18 were female. Their age was 39.5 ± 22.1 years. Histopathological examination showed that the tumor was well-circumscribed and surrounded by abundant fiber matrices, consisted of many basaloid cells forming clusters or interlacing cords with surrounding cells arranged in a fence-like pattern. Tumor cells differentiated into dermal papilla cells to different extents, and varying amounts of keratinous cysts were observed. RCM showed bud-like downward extension of cord-like cells at the dermo-epidermal junction in 8 patients, which tended to be arranged in a fence-like pattern; seemingly lobulating nodular tumor masses were scattered in the dermis in 18 patients, which appeared as extended hypoechoic structures, with no constriction gap between tumor masses and surrounding tissues; tumor masses were surrounded by moderately to highly refractive amorphous substance in 16 patients; characteristic hair papilla structures suspected to be derived from primary differentiation were observed in 16 patients; keratinous cysts were clearly observed in 20 patients. Dermoscopy clearly showed that homogeneous pearl-white structures in 20 patients, and linear telangiectasia in 10 patients. Conclusion RCM features of trichoepithelioma are highly consistent with its histopathological features, so reflectance confocal microscopy can serve as an efficient method for auxiliary and differential diagnosis.

Key words: Microscopy, confocal, Dermoscopy, Trichoepithelioma, Histopathology

引用本文

姜倩 陈红英 马玲 黄萌 夏云 陈金波 陈柳青. 毛发上皮瘤的皮肤影像学特征分析[J]. 中华皮肤科杂志, 2020,53(2):133-135. doi:10.35541/cjd.20190287

Jiang Qian, Chen Hongying, Ma Ling, Huang Meng, Xia Yun, Chen Jinbo, Chen Liuqing. Analysis of imaging characteristics of trichoepithelioma[J]. Chinese Journal of Dermatology, 2020, 53(2): 133-135.doi:10.35541/cjd.20190287