CAJ | 학술논문

目的探讨坐骨结节囊肿伴缺血性筋膜炎的临床表现、病理形态特征及鉴别诊断.方法对2例坐骨结节囊肿伴缺血性筋膜炎病例进行组织形态学、免疫组织化学分析,并复习相关文献.结果缺血性筋膜炎常见于老年患者,有长期卧床病史,好发于躯体突出部位的皮下组织.形态学表现:病变的中央为纤维素样坏死区,坏死区周围为增生的纤维母细胞和薄壁小血管所形成的肉芽肿样区域,可见大的、核仁明显、胞质深染、具有异型性的纤维母细胞.免疫组化:纤维母细胞vimentin(+),CK(-).结论 ①缺血性筋膜炎是一种罕见病变,临床表现及形态学与肉瘤相似,容易误诊;②以前报道认为该病变常见于年老体弱、长期卧床的患者,本文发现,在坐骨结节囊肿基础上也可发生该病变.
목적 탐토좌골결절낭종반결혈성근막염적림상표현、병리형태특정급감별진단.방법 대2례좌골결절낭종반결혈성근막염병례진행조직형태학、면역조직화학분석,병복습상관문헌.결과 결혈성근막염상견우노년환자,유장기와상병사,호발우구체돌출부위적피하조직.형태학표현:병변적중앙위섬유소양배사구,배사구주위위증생적섬유모세포화박벽소혈관소형성적육아종양구역,가견대적、핵인명현、포질심염、구유이형성적섬유모세포.면역조화:섬유모세포vimentin(+),CK(-).결론 ①결혈성근막염시일충한견병변,림상표현급형태학여육류상사,용역오진;②이전보도인위해병변상견우년로체약、장기와상적환자,본문발현,재좌골결절낭종기출상야가발생해병변.
Objective To investigate the clinicopathologic features, diagnosis and differential diagnosis of ischial tuberosity bursitis complicated with ischemic fasciitis. Methods Two cases of ischial tuberosity bursitis complicated with ischemic fasciitis were reported. Based on histological and immunohistochemical studies and the literature was reviewed. Results Ischemic fasciitis occurred primarily in the deepsubcutis of the aged patients who were frequently immobilized or debilitated. It had a priority to occur over body prominences. The characteristic histologic appearances of the lesions were fibronoid necrosis in the central zones and myxoid change involving lobules of adipose tissue. These areas were surrounded by a peripheral rim of granulation tissue consisting of capillary and fibroblasts containing atypical, enlarged degenerated fibroblasts with abundant basophilic cytoplasm, large hyperchromatic, smudged nuclei, and prominent nucleoli. Immunohistochemical staining showed the fibroblasts were positive for vimentin and MSA, negative for fasciitis may occur in the base of ischial tuberosity patients, besides the above mentioned.