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asbryobvrz · Wysłany: Nie 7:38, 13 Mar 2011

1 case of disseminated xanthoma

Large number of tablets needle red papules, no symptoms, no attention. After the papules gradually increased, increased, gradually involving the entire face and the left armpit, not accompanied by itching. Had received treatment in local hospitals, the specific treatment is unknown. 2 years ago,[link widoczny dla zalogowanych], the neck, waist, lower abdomen began to emerge like skin lesions, skin lesions continued to increase in the original, larger, part of the fusion, had lesions outside the hospital from pathological examination, inspection reports show treatment. Began six months ago, polydipsia, polydipsia, polyuria (urine specific unknown), anorexia, malaise usually physical health, no high-fat diet, alcohol and tobacco addiction, no similar disease in two generations of the family, no high cholesterol medical disease and family history of diabetes: general good, normal blood pressure, body lymph nodes not enlarged heart and lung (a), liver and spleen is not. Dermatology examination: face and neck, armpits, waist, groin symmetrical scattered hundreds of millet to the size of the red and yellow beans, red papules, most of the integration into the plaque, especially in the face and neck, armpit obvious. Papules with smooth surface, clear boundary, quality in rigid,[link widoczny dla zalogowanych], non-tender (Figure 1). Lip mucosa, cheek shows a large yellow papules mung bean. Conjunctiva, cornea and bronchial mucosa damage. Daily urine output 500l0 ~ 60o0mL. Laboratory tests: blood, urine and stool normally. Liver function tests: triglyceride fTG) 2.50mmol / L (normal range 0.48 ~ 1.88mmo1 / L, following the same), total cholesterol, C) 5.16mmol / L (2.90 ~ 6.O0mmol / L ), apolipoprotein A A1.41L (0.73-1.69g / L), apolipoprotein A B0.90g / L (O.58 ~ 1_38g / L), high density lipoprotein face and neck, armpits, lips many Mucosal symmetrical to soybeans rhubarb miliary red papules disseminated xanthoma Figure 1 Clinical lesions Received Date :2002 -07-17; Revised Date :2002-10-14 director: Li Hui protein fHDL) 1. O0g/Lf0.70 ~ 2. O0g / L),[link widoczny dla zalogowanych], low density lipoprotein (LDL) 3.77g / L (1.80 ~ 4.50g / L); lipoprotein electrophoresis normal. Normal renal function. Normal fasting blood glucose, postprandial 2h oral glucose tolerance test glucose l1.1mmol / L. Chest X-ray film, abdominal B ultrasound, head CT scan was normal. Cranial magnetic resonance imaging (MRI) scan showed increased: the limitations of low signal on the right side of pituitary, saddle up every bulging, consider pituitary adenoma. Shallow water of a Canadian ban dermal deposition of foam cells, lymphocyte infiltration, Lei diabetes insipidus testing 2. Lesions (right arm) Figure disseminated xanthoma pathology of pathology, as shown: a large number of foam cells in the dermis shallow, with varying degrees of lymphocyte infiltration, and to see a small number of multinucleated giant cells (Figure 2). Pathological diagnosis of xanthoma. Clinical and pathologic diagnosis of disseminated xanthoma. Treatment: Oral forests (to amine vasopressin) 0.2g, 2 times a day, after treatment polydipsia, polydipsia, polyuria quickly ease the daily urine volume reduced from 5000 ~ 6000mL 2000mL about the spirit, loss of appetite was better, but no change in the skin xanthomas, are still under follow-up. Discussion of disseminated xanthoma is a rare non-X histiocytosis associated with yellow tumor, is a reactive histiocytosis, lipid accumulation is secondary to widespread skin xanthoma associated with diabetes insipidus disease is characterized by unknown etiology. 1 to 70 years old may be the disease, mainly adults, twice as many men as for women, skin lesions occur in the body flexures and folds, about 39% of patients had violated the emergence of the hypothalamic-pituitary diabetes insipidus, but mild symptoms. Lipids were normal, a few may have elevated cholesterol and blood lipids. This case has the typical clinical manifestations and pathological changes. The major clinical juvenile xanthogranuloma should be, multiple cell tumor, Langerhans histiocytosis differentiated from psychosis. Juvenile xanthogranuloma with infant onset, 1 to 2 years old self-healing features; multiple histiocytoma to spontaneous regression of the lesions in groups without fusion tendencies, pathological cell infiltration was a single organization,[link widoczny dla zalogowanych], no multinucleated giant cells. Langerhans cell histiocytosis also known as Histiocytosis X,[link widoczny dla zalogowanych], is divided into 3 clinical: Let-terer-Siwe disease, Hand-Schuller-Christian disease and eosinophilic granuloma of bone. Mainly disseminated xanthoma with the Hand-Schuller-Christian disease differences, Hand-Schuller-Christian disease in childhood, there diabetes insipidus, skull defects, exophthalmos triad, the histopathology in tissue cell infiltration and Buffet infiltration of inflammatory cells in the opposite sex, no yellow tumor cells.