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本文报告一例男性,66岁 Kaposi 肉瘤。病程半年。双侧手掌、足蹠发生指盖大到绿豆粒大,在指、趾的腹面,隆起于皮肤表面的黑红色结节;阴茎的冠状沟皆有可见绿豆大红褐色结节,除走路不适外,无自觉状。两肺上野有陈旧性肺结核,胃肠透视未见异常。病理组织学所见真皮有血管增生,外皮细胞增殖,混以纤维母细胞,病灶周围有炎性细胞浸润,符合 Kaposi 肉瘤。用5—氟脲嘧啶治疗病情好转。在讨论中论述了本病多见于40～70岁,多累及男性。虽各脏器都可受累,但以皮肤为主,可占75～94%,好发于四肢的远端,粘膜亦可受累。皮损主要为大小不一的黑红色结节。由于病灶而造成的死亡,约有10～20%,多因消化道、肺病灶大出血、下肢溃疡等所致。病理改变早期类似良性血管瘤和肉芽肿样改变,晚期类似血管内皮瘤、血管周细胞瘤、纤维肉瘤所见。本病系多中心病灶的系统疾病。病因不明。但多认为是一种良性血管病。治疗可采用外科切除,放射线疗法、化学疗法。
This article reports one case of a 66-year-old Kaposi’s sarcoma. The course of illness lasted for six months. Bilateral palms and foot spasms occur with large lids and large mung beans. On the ventral surface of the fingers and toes, they rise up on the black and red nodules on the surface of the skin. The coronal sulcus of the penis has visible mung bean red-brown nodules, except for discomfort in walking. Unconsciously. There were old tuberculosis in the Ueno lungs, and no abnormalities were observed in the gastrointestinal tract. Histopathology revealed dermal hyperplasia of the dermis, proliferation of epithelial cells, fibroblasts, and infiltration of inflammatory cells around the lesion, consistent with Kaposi’s sarcoma. Treatment with 5-fluorouracil improved. In the discussion discussed the disease more common in 40 to 70 years old, involving men. Although all organs can be affected, but mainly skin, can account for 75 to 94%, occurs in the distal extremities, the mucous membrane can also be involved. The skin lesions are mainly black and red nodules of different sizes. The death caused by lesions is about 10 to 20% due to digestive tract, massive hemorrhage of lung lesions, and ulcers of the lower extremities. Pathological changes were similar to benign hemangiomas and granuloma-like changes in the early stage, and were similar to those seen in the late stage of the hemangioendothelioma, perivascular tumor, and fibrosarcoma. The disease is a systemic disease with multiple centers. The cause is unknown. However, it is considered to be a benign vascular disease. Treatment can be surgical resection, radiation therapy, chemotherapy.