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投稿者：橘 充弘 |
2006/05/26(Fri) |
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Case185 |
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引掻いたあとでしょうか？表皮剥脱し、壊死滲出物の付着と、真皮浅層の肉芽組織増生が認められ、出血も目立ちます。一部では細菌塊の付着を伴っています。 |
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| 2 |
投稿者： Black Jack |
2006/05/28(Sun) |
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case185 |
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Clusters of proliferating small blood vessels are
observed in the dermis of ulcerated hemorrhagic skin lesion, The
vascular proliferation appears to be reactive rather than neoplastic.
Pyogenic granuloma and angiolymphoid hyperplasia are unlikely, but
pseudo-Kaposi sarcoma (acroangiodermatitis) resulting from venous
insufficiency could be a candidate. |
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3 |
投稿者： KEIGO |
2006/05/28(Sun) |
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Case185:Epithelioid hemangioma |
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I can see a prominent proliferation of small vessels
lined by
plump, epithelioid endothelial cells and few eosinophils, lymphoid
follicles.
I think that it is a reactive lesion following trauma, skin ulcer
and so on. |
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4 |
投稿者：Chang |
2006/05/28(Sun) |
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case 185 |
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I suspect pseudo-Kaposi's sarcoma. The skin biopsy
location maybe provide the clue of this entity. |
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| 5 |
投稿者：Black Jack |
2006/05/29(Mon) |
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case185 review |
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Clustered vascular proliferation in the dermis of ulcerated
hemorrhagic skin lesion looks like reactive rather than neoplastic.
Then, pyogenic granuloma (PG), angiolymphoid hyperplasia with eosinophilia
(ALHE) and pseudo-Kaposi sarcoma (PKS) can be considered for this
vascular proliferation. PG is unlikely because the proliferating small
vessels are thick walled with myopericytic envelope. ALHE is not confirmed
because there is neither typical inflammatory reaction nor epithelioid
endothelial morphology in the given images. PKS is also not confirmed
because the location has not been described. Since blood vessels narrowed
by plump endothelial cells and aassociated inflammatory infiltrate
can emerge in both of ALHE and PKS, additional data would be appreciated
to make one out. |
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| 6 |
投稿者：Chang |
2006/05/29(Mon) |
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case 185 (2) Stasis ulcer |
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The provider give the clinical information as the specimen
taken from leg ulcer. In the past, it is hard for me to tell stasis
dermatitis from acroangiodermatitis. But stasis dermatitis prone to
stasis ulcer and more fibrosis or sclerosing panniculitis even more
hemosiderin. In these pictures, numerous RBC extravasculation and
sclerosis-like lesions are both noted. If the lesions got older, the
hemosiderin maybe develop. So, stasis ulcer canbe more corrective
diagnosis than acroangiodermatitis in my limited experience. Anyway,
I learn a lot from Black Jack's rationale. THANKS. |
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| 7 |
投稿者：大日輝記 |
2006/05/30(Tue) |
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Case 185: Glomus tumor |
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腫瘍については上記と考えました。分裂像は目立たず良性と考えます。２次的傷害などで潰瘍が形成されたのでしょうか。 |
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| 8 |
投稿者：Black Jack |
2006/06/01(Thu) |
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case185 review2 |
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You tell me that it is a leg ulcer. Then I discard the
possibility of ALHE. Venous stasis can induce eczema, ulcer, angiogenesis
and sclerosis in legs depending on its severity and duration. It seems
not so curious that the mixed lesion can develop. Is there any possibility
of eccrine angiomatous hamartoma predisposed in the leg? And, what
is a black spot seen in the first two pictures? |
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