摘要
目的探讨皮肤Merkel细胞癌(MCC)的临床病理特征、诊断和鉴别诊断及其预后。方法对2例MCC进行临床病理资料分析及免疫组织化学检测,并复习近10年相关文献。结果2例患者均为老年女性。病例1病变有2处,分别位于乳腺及左下肢股部皮肤,乳腺肿块为首发症状;病例2病变位于面颊部。2例肿瘤主要位于真皮及皮下组织,均由大小一致的嗜碱性细胞构成,胞浆稀少,细胞核呈圆形或卵圆形,核分裂易见。病例1左下肢病变伴多灶坏死,腋窝及腹股沟前哨淋巴结均见转移癌;病例2紧邻肿瘤组织局灶表面鳞状上皮呈原位癌。免疫组织化学标记显示:2例肿瘤细胞CK20均呈特征性核旁点阳,神经内分泌标记均阳性。结论MCC是一种少见、恶性程度高的疾病,近年发病率有所上升,与其他小细胞肿瘤的鉴别十分重要,远处转移预后差。
Objective To investigate the clinicopathological features,diagnosis,differential diagnosis and prognosis of Merkel cell carcinoma(MCC).Methods Clinicopathologic data were analyze and immunohistochemical determination was performed in 2 cases of MCC.Furthermore,the related literature in recent 10 years were reviewed.Results The two patients were elderly women.Patient 1 had 2 lesions,which were respectively located in the mammary gland and left lower extremity femoral skin.The breast mass was the first symptom.In patient 2,the lesion was located on the cheek.The tumors were mainly located in the dermis and subcutaneous tissues,and were composed of uniform-sized basophilic cells with sparse cytoplasm,round or oval nucleus and common nuclear division.In patient 1,left lower extremity lesion was associated with multiple focal necrosis,and metastatic carcinoma was found in the axillary and inguinal sentinel lymph nodes.In patient 2,preinvasive carcinoma was observed in the focal squamous epithelium of tissue adjacent to the tumor.Immunohistochemistry indicated that tumor cells showed characteristic perinuclear dot-like staining and positive neuroendocrine marker expression.Conclusion MCC is a rare and malignant disease with poor prognosis of distant metastasis.The incidence of MCC has increased in recent years.It is very important to distinguish MCC from other small cell tumors.
作者
刘松鸽
李晓娜
侯宏敏
王军凯
LIU Song-ge;LI Xiao-na;HOU Hong-min;WANG Jun-kai(Department of Pathology,Xuchang Central Hospital Affiliated to Henan University of Science and Technology,Xuchang 461000,China)
出处
《实用临床医学（江西）》
CAS
2019年第12期1-3,11,I0002,共5页
Practical Clinical Medicine
关键词
MERKEL细胞癌
临床病理
鉴别诊断
Merkel cell carcinoma
clinicopathology
differential diagnosis
