Rainbow pattern in Kaposi's sarcoma under polarized dermoscopy: a dermoscopic pathological study
Rainbow pattern in Kaposi's sarcoma under polarized dermoscopy: a dermoscopic pathological study
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DOI：
10.1111/j.1365-2133.2008.08940.x
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发表时间：
2009-04-01
影响因子：
10.3
通讯作者：
Hu, S. C-S.
中科院分区：
文献类型：
--
作者：
Cheng, S-T.;Ke, C-L. K.;Hu, S. C-S.
背景我们以前发现Kaposi肉瘤（KS）在偏光皮肤镜下的特征是蓝红色着色、鳞状表面、小棕色球，最明显的是多色的“彩虹图案”。方法采用偏振光皮肤镜对7例经病理证实的KS患者的100多个皮损进行检查。还检查了63例其他各种皮肤血管和非血管性肿瘤患者。皮肤镜下显示彩虹图案的KS病变和皮肤镜下缺乏彩虹图案的KS病变被切除，皮肤镜下特征与组织病理学结构进行比较。其他血管肿瘤的皮肤镜模式也与组织学特征进行了比较。此外，皮肤镜的功能和组织结构的变化进行了评估手术治疗前和手术治疗后的KS。结果的基础上的评价与偏光皮肤镜，彩虹图案被认为是一个高度特异性皮肤镜特征KS。组织学KS病变显示彩虹图案偏振光皮肤镜下表现出血管管腔丰富的模式紧密排列的“背靠背”的血管结构，而组织学KS病变没有彩虹图案显示血管管腔贫穷的模式与血管管腔进一步分开的干预间质和细胞组织。其他血管肿瘤没有表现出彩虹图案，其组织学特征是由大量的基质和细胞组织分隔的大小不一的血管结构。在一名KS患者中，彩虹图案的消失与闭塞的血管结构手术消融therapy.Conclusions彩虹图案在KS与血管管腔丰富的组织学亚型，是不明显的血管管腔穷人亚型和消失后，总肿瘤切除。因此，KS中血管的潜在结构排列可能决定了在偏光皮肤镜检查中是否可以看到彩虹图案。
Background We found previously that the features of Kaposi's sarcoma (KS) under polarized dermoscopy are characterized by a bluish-reddish coloration, a scaly surface, small brown globules and, most distinctively, the multicoloured 'rainbow pattern'.Objectives To evaluate the significance of the rainbow pattern on dermoscopy as a diagnostic feature in KS, and to demonstrate that it is associated with the unique vascular structure of the tumour.Methods More than 100 lesions from seven patients with histologically proven KS were examined with polarized light dermoscopy. Sixty-three patients with various other cutaneous vascular and nonvascular tumours were also examined. KS lesions exhibiting the rainbow pattern and KS lesions lacking the rainbow pattern on dermoscopy were excised, and dermoscopic features were compared with histopathological structures. The dermoscopic patterns of other vascular tumours were also compared with histological features. In addition, the changes in dermoscopic features and histological structures were assessed before and after surgical therapy in one patient with KS.Results On the basis of evaluations with polarized dermoscopy, the rainbow pattern was found to be a highly specific dermoscopic feature for KS. Histology of KS lesions showing the rainbow pattern under polarized light dermoscopy demonstrated a vascular lumen-rich pattern of closely arranged 'back-to-back' vascular structures, whereas histology of KS lesions without the rainbow pattern showed a vascular lumen-poor pattern with vascular lumina separated further apart by intervening stromal and cellular tissue. Other vascular tumours did not exhibit the rainbow pattern and were characterized histologically by variably sized vascular structures separated by substantial amounts of stromal and cellular tissue. In one patient with KS, disappearance of the rainbow pattern was associated with obliteration of the vascular structure following surgical ablation therapy.Conclusions The rainbow pattern in KS is associated with the vascular lumen-rich histological subtype, is not manifest in the vascular lumen-poor subtype and disappears following total tumour removal. Therefore, the underlying structural arrangement of the vessels in KS may determine whether or not the rainbow pattern can be seen on polarized dermoscopy.