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患者女,58岁。双上肢、腰背部皮疹3年余,加重并泛发全身结节1年。体检:头皮、颜面、颈部、躯干、双上肢可见密集分布的直径0.5~3.0cm大小不规则的暗红色浸润性斑块、隆起性结节、边界尚清楚,质地较韧,无触痛。皮损组织病理检查(胸部):表皮除角质层外整个受累,真皮全层及部分脂肪组织弥漫分布单个核细胞浸润,胞质淡染,胞核圆形、不规则或分叶状,部分细胞可见核沟,核仁不明显,核分裂相罕见。免疫组织化学:CD1a(+),S100(+),CD68(+)。电镜检查未找到Birbeck颗粒。诊断:未定类细胞性组织细胞增生症。
Female patient, 58 years old. Two upper limbs, lower back rash more than 3 years, aggravating and generalized nodules for 1 year. Physical examination: Scalp, face, neck, torso, densely distributed dark red infiltrative plaques of 0.5-3.0 cm in diameter, with prominent nodules on the upper extremities. Skin lesions histopathological examination (chest): the epidermis in addition to the entire involvement of the stratum corneum, the entire dermis and some adipose tissue diffuse distribution of mononuclear cells, light cytoplasm, round nuclei, irregular or lobulated, some cells Visible nuclear ditch, nucleoli are not obvious, mitotic phase rare. Immunohistochemistry: CD1a (+), S100 (+), CD68 (+). Electron microscopy did not find Birbeck particles. Diagnosis: Undetermined class of cellular histiocytosis.