摘要
目的探讨藏毛窦囊肿的临床病理特点。方法收集北京市垂杨柳医院病理科2015—2020年归档的藏毛窦囊肿18例,回顾性分析其临床病理特征。结果 18例藏毛窦囊肿患者年龄16~53岁,平均25岁,男14例,女4例,17例位于骶尾部,1例位于颈部。骶尾部藏毛窦临床表现为肿块隆起,有硬结,触痛,破溃流脓伴窦道形成。颈部藏毛窦临床表现为黄豆大小隆起,偶有红肿破溃,质稍硬。病理形态学显示部分表皮增生、上皮脚延长,真皮及皮下脂肪组织伴大量急、慢性炎细胞浸润,泡沫状组织细胞及异物巨细胞反应,炎性肉芽组织增生伴窦道形成,窦道周围可见角化物、毛根或鳞状上皮残留。免疫组化结果:CD38、CD138、Lambda、Kappa(+),CKpan(上皮细胞+)、Ki-67增殖指数、Ig G、Ig G4均约10%(+),p53、CD56(-)。随访6个月至5年,患者手术切除后均创口愈合,预后良好,无复发。结论藏毛窦囊肿通常为良性病变,但也有癌变的报道,并且容易误诊,所以手术切除的藏毛窦组织都应该进行组织病理学评估。
Objective To explore the clinicopathologic features of pilonidal sinus. Methods Clinicopathologic features were analyzed in 18 patients with pilonidal sinus at the Department of Pathology,Beijing Chuiyangliu Hospital from 2015 to2020. Results Of the 18 patients,the median age at diagnosis was 25 years( range,2-86 years),and the male:female ratio was approximately 14 ∶ 4. The lesion located in sacrococcygeal region( 17 cases) and neck( 1 case).Sacrococcygeal pilonidal sinus clinically presented as swelling of the mass,induration,tenderness,and ulceration with sinus formation. The pilonidal sinus in the neck clinically presented with a soybean-sized mass,with occasionally red and swollen,and slightly hard. Pathological morphology showed partial epidermal hyperplasia,epithelial prolongation,dermal and subcutaneous adipose tissue with a large number of acute and chronic mixed inflammatory cell and plasma cell infiltration,foamy tissue cells and foreign-body giant cell reactions,inflammatory granulation tissue proliferation with sinus formation,keratose,hairy root or squamous epithelium residue around the sinus. Immunohistochemical staining showed CD38,CD138,Lambda,Kappa and CKpan( epithelial cells) were positive;Ki-67 positive rate was about 10%,CK7 and EMA were weakly positive( 10%),while p53 and CD56 were negative. All patients were followed up for 6 months to 5 years. All patients underwent wound healing after surgical resection. The prognosis was good and there was no recurrence.Conclusion The pilonidal sinus is usually a benign lesion,but it is also reported as cancerous transformation,and it is easy to be misdiagnosed. Therefore,all pilonidal sinus surgery specimens should be histopathologically evaluated.
作者
孔令红
刘晓刚
王丽宁
张新鹏
薛慧忠
焦阳
KONG Ling-Hong;LIU Xiao-Gang;WANG Li-Ning;ZHANG Xin-Peng;XUE Hui-Zhong;JIAO Yang(Department of Pathology,Beijing Chuiyangliu Hospital,Beijing 100022,China)
出处
《诊断病理学杂志》
2021年第5期332-336,共5页
Chinese Journal of Diagnostic Pathology
基金
北京市朝阳区科技计划项目(CYSF181210)。
关键词
藏毛窦
骶尾
临床病理特征
鉴别诊断
Pilonidal sinus
Sacrococcyx
Clinicopathological features
Differential diagnosis
