硬化性脂肪肉芽腫 (Sclerosing Lipogranuloma)
臨床特徵 (Clinical Features)
- 硬化性脂肪肉芽腫 (sclerosing lipogranuloma)（即 paraffinoma）可侵犯陰囊、陰莖，極少數情況下也可侵犯副睪 (epididymus)。
- 它通常代表一種對外源性物質（多為 paraffin、silicone，甚至 mineral oil 與 Vaseline）的組織反應，最常見於睪丸旁區域 (paratesticular area)，繼發於注射增大尺寸用物質之後。
- 極少數硬化性脂肪肉芽腫的病例似乎屬於原發性，在日本較為常見，好發於泌尿生殖系統 (genitourinary system)，但也可發生於其他部位，包括直腸。
- 曾有報告描述肉芽腫性陰莖結節 (granulomatous penile nodules，即 Tanko nodules)，係由於在陰莖皮膚下植入玻璃球所致。
組織病理特徵 (Histopathology)
- 真皮內可見異物型肉芽腫反應 (foreign body-type granulomatous reaction)。
- 「脂質」空泡 (‘lipid’ vacuoles) 被緻密的纖維組織所包繞。
- 曾有文獻記載一例原發性硬化性脂肪肉芽腫出現罕見的廣泛性壞死 (extensive necrosis)。
圖 12-149：陰囊鈣質沉著症 (scrotal calcinosis)：鈣沉積物以蘇木精與伊紅 (hematoxylin and eosin) 染成紫色。有時可辨識出先前存在的表皮樣囊腫 (epidermoid cyst)。
Fig. 12.149 Scrotal calcinosis: the calcium deposits stain purple with hematoxylin and eosin. Sometimes a preexistent epidermoid cyst can be identified.
圖 12-150：人為性皮膚炎 (dermatitis artifacta)：陰莖體 (penile shaft) 有嚴重破壞。From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.
Fig. 12.150 Dermatitis artifacta: there is gross destruction of the penile shaft. From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.
圖 12-151：人為性皮膚炎 (dermatitis artifacta)：注意環周性潰瘍 (circumferential ulceration)。Reproduced with permission from Bunker C.B. and Mallon E., Management of penile erosions and ulcers, Postgraduate Doctor Middle East, 1998;21:163–168. Copyright © Professional Managerial and Healthcare Publications Limited. From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.
Fig. 12.151 Dermatitis artifacta: note the circumferential ulceration. Reproduced with permission from Bunker C.B. and Mallon E., Management of penile erosions and ulcers, Postgraduate Doctor Middle East, 1998;21:163–168. Copyright © Professional Managerial and Healthcare Publications Limited. From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.
圖 12-152：人為性皮膚炎 (dermatitis artifacta)：此為臀溝 (natal cleft) 的視野。注意中央的潰瘍 (central ulceration) 與周圍的苔癬化 (lichenification)。From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.
Fig. 12.152 Dermatitis artifacta: this is a view of the natal cleft. Note the central ulceration and surrounding lichenification. From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.