皮肤棘阿米巴病:两例不同的组织病理表现。

IF 1.1 4区 医学 Q3 DERMATOLOGY
Nadia Siddiqui, Bicong Wu, Lindsay Gunnell, Evan George, Oliver Chang
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引用次数: 0

摘要

棘阿米巴是一种自由生活的阿米巴原虫,已知最常引起隐形眼镜使用者阿米巴角膜炎和免疫功能低下患者阿米巴肉芽肿性脑炎。皮肤棘阿米巴病作为单一器官的表现是不常见的。我们报告两个在我们部门看到的病例。病例一是一名23岁的系统性红斑狼疮和全血细胞减少症住院患者,他在四肢急性发展为结节。活检显示皮下脂肪有淋巴组织细胞炎症和局灶性凝固性坏死。h&e染色切片可见棘阿米巴滋养体和囊肿,PAS和GMS染色突出。PCR检测结果为棘阿米巴原虫阳性。病例二为81岁的弥漫性大b细胞淋巴瘤患者,表现为三周的四肢溃疡性结节病史。左臂活检显示中性粒细胞和组织细胞混合深层真皮浸润,右臂活检显示肉芽肿性炎症。H&E和pas染色切片可见棘阿米巴滋养体和囊泡,经PCR证实为棘阿米巴。在免疫功能低下患者的皮肤结节活检中应考虑皮肤棘阿米巴病。组织病理学炎症变化是可变的和非特异性的,而生物体由于其与组织细胞的相似性而容易被忽视。熟悉这些特征对于准确、及时的诊断至关重要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Cutaneous Acanthamoebiasis: Two Cases Highlighting Diverse Histopathologic Findings.

Acanthamoeba is a free-living ameba, known to most commonly cause amebic keratitis in contact lens users and granulomatous amebic encephalitis in immunocompromised patients. Cutaneous Acanthamoebiasis as a single-organ manifestation is less common. We report two cases seen in our department. Case one is a 23-year-old hospitalized patient with systemic lupus erythematosus and pancytopenia who acutely developed nodules on the extremities. Biopsy showed lymphohistiocytic inflammation and focal coagulative necrosis in the subcutaneous fat. Acanthamoeba trophozoites and cysts were apparent in H&E-stained sections and highlighted by PAS and GMS stains. PCR studies were positive for Acanthamoeba species. Case two is an 81-year-old with diffuse large B-cell lymphoma on idelalisib, who presented with a three-week history of ulcerating nodules on the extremities. Biopsy from the left arm exhibited a mixed deep dermal infiltrate with neutrophils and histiocytes while biopsy from the right arm exhibited granulomatous inflammation. Acanthamoeba trophozoites and cysts were apparent in H&E and PAS-stained sections, confirmed to be Acanthamoeba by PCR. Cutaneous Acanthamoebiasis should be considered in biopsies of cutaneous nodules from immunocompromised patients. The histopathologic inflammatory changes are variable and non-specific, while the organisms are easily overlooked due to their resemblance to histiocytes. Familiarity with these features is essential for accurate, timely diagnosis.

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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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