中华皮肤科杂志

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老年慢性多灶性朗格汉斯细胞增生症一例

符美华1, 顾黎雄1, 陈伟1, 陈辉2, 李和莲1, 刘维达1, 孙建方1   

  1. 1. 中国医学科学院皮肤病研究所, 南京 210042;
    2. 华中科技大学同济医学院附属同济医院皮肤科
  • 收稿日期:2006-11-23 出版日期:2007-10-15 发布日期:2007-10-15
  • 通讯作者: 刘维达,email:liumyco@hotmail.com E-mail:liumyco@hotmail.com

A case of Langerhans cell histiocytosis in a 76-year-old woman

FU Mei-hua1, GU Li-xiong1, CHEN Wei1, CHEN Hui2, LI He-lian1, LIU Wei-da1, SUN Jian-fang1   

  1. Institute of Dermatology, Chinese Academy of Medical Sciences, Nanjing 210042, China
  • Received:2006-11-23 Online:2007-10-15 Published:2007-10-15

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摘要： 76岁女性患者,外阴部溃疡伴突眼5年,双侧乳房下红斑糜烂半年,尿崩症3个月。皮损为红斑、丘疹,部分表面有褐红色痂,主要位于双侧乳房下皱襞处、双腋窝及腰部。皮损组织病理检查显示真皮浅层局限性胞质丰富的大细胞和淋巴样细胞浸润,并见部分大细胞移入表皮或毛囊上皮,细胞核大深染,有异形性,核周有空晕,免疫组化显示这些大细胞S100、CD1a阳性,CD68阴性。根据患者的临床表现、组织病理和免疫组化结果,确诊为慢性多灶性朗格汉斯细胞增生症。

关键词: 组织细胞增多症, 郎格汉斯细胞, 老年人

Abstract: A 76-year old female patient was admitted to hospital for a 5-year history of vulval ulcer and exophthalmos,6-month history of erythema and erosions under the breasts,and 3-month history of diabetes insipidus.The lesions included erythematous patches,and papules partially covered with crusts,which were mainly located at the inframammary folds,axillary fossa and waist.Histopathologically,there was a local infiltration with large cells containing abundant cytoplasm,lymphoid cells in the upper dermis;a number of the large cells were observed in the epithelium or follicular epithelium.These large cells,which were positive for S100,CD1a,but negative for CD68,often had a large and atypical nucleus with halo around it.The case is diagnosed as Langerhans cell histiocytosis according to the clinical feature,histopathological and immunohistochemical findings.

Key words: Histiocytosis, Langerhans cell, Aged