Particular histological features of a case of Sweet's syndrome induced by G-CSF
Particular histological features of a case of Sweet's syndrome induced by G-CSF
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DOI：
10.1016/s0151-9638(04)93617-4
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发表时间：
2004-04-01
影响因子：
0.9
通讯作者：
Dubertret, L
中科院分区：
文献类型：
--
作者：
Abecassis, S;Ingen-Housz-Oro, S;Dubertret, L
背景Sweet综合征可能发生在骨髓发育不全期间，特别是在用外源性生长因子如G-CSF治疗后。在这种情况下，Sweet综合征表现出特殊的组织学特征，我们在此详细观察。病例报告。一位50岁的男性在自体干细胞移植前接受动员化疗治疗多发性骨髓瘤。在G-CSF发作后4天，患者出现发热性全身性皮疹，伴有渗出性浸润性病变。皮肤活检的组织学检查显示与非典型黄色化组织细胞和血管增生相关的嗜酸性浸润，伴有显著的内皮肿胀。短期口服糖皮质激素治疗是有效的。Sweet综合征的典型组织学特征是皮肤嗜中性粒细胞浸润伴水肿。在我们的病人中，我们注意到在皮肤嗜中性粒细胞浸润中存在非典型组织细胞。这些组织细胞被描述为由G-CSF引起的斑丘疹，不应与血液病相关的恶性浸润相混淆。血管增生可能与G-CSF的血管生成特性有关。这些组织学特征的知识将使临床医生和组织学家认识到适当的诊断。
Background. Sweet's syndrome may occur during medullar aplasia, especially after treatment with exogenous growth factors such as G-CSF. In this context, Sweet's syndrome presents particular histological features that we detail in this observation.Case report. A 50 year-old man was treated for multiple myeloma with a mobilizating chemotherapy prior to autologous stem cell transplantation. Four days after the onset of G-CSF, he presented with a febrile generalized eruption of erythematous infiltrated lesions. Histological examination of a skin biopsy showed a neutrophilic infiltrate associated with atypical xanthomized histiocytes and vascular hyperplasia with marked endothelial turgescence.. Treatment with a short cause of oral corticosteroids was efficient.Discussion. The classical histological features of Sweet's syndrome consist in a dermal neutrophilic infiltrate with edema. in our patient, we noticed the presence of atypical histiocytes among the dermal neutrophilic infiltrate. These histiocytes are described in maculo-papular eruptions induced by G-CSF, and should not be confused with a malignant infiltrate associated with a hemopathy. Vascular hyperplasia may be related to the angiogenic properties of G-CSF. Knowledge of these histological features would enable clinicians and histologists to recognize the appropriate diagnosis.