摘要
目的探讨微囊性附属器癌的病理学形态特征、诊断及鉴别诊断。方法收集2例微囊性附属器癌患者的临床资料,采用常规石蜡切片HE染色和免疫组织化学染色,复习相关文献并结合临床特征综合分析。结果2例患者皮损位于上唇及面部,病史为50余年及10余年,临床行肿瘤切除术。光镜下肿瘤位于真皮,向皮下浸润性生长。瘤细胞由基底样细胞及鳞状细胞呈条索状、小巢状或腺管样排列;肿瘤浅层见大量角质囊肿形成。肿瘤细胞圆形或卵圆形,胞浆略嗜酸,细胞核异型性小,核分裂罕见。免疫组化染色显示,所有肿瘤细胞表达CK5/6,CK7、EMA及CEA在有腺体特征的区域阳性表达,腺管周围细胞P63阳性,而其中央的细胞阴性,CK20阴性,Ki-67增殖指数<5%。结论微囊肿性附属器癌是一种罕见的具有向毛囊和汗腺双向分化的低度恶性附属器肿瘤,预后良好,该肿瘤具有独特的病理形态学特征,主要与结缔组织增生性毛发上皮瘤、基底细胞癌、汗管瘤、鳞状细胞癌等相鉴别。
Objective To investigate the morphological characteristics,pathologic diagnosis and differential diagnoses of microcystic adnexal carcinoma.Methods The clinical-pathological features of two cases were reviewed,routine hematoxylineosin and immunohistochemistry staining were performed and the literatures were reviewed.Results Skin lesions occurred on the upper lip and face of patients,with a history of more than 50 years and more than 10 years,and the tumor resection was performed.Histologically,the tumor was located in dermins and infiltrated subcutaneously.The cells were demonstrated in nest,strips or glandular tubular structures which were composed of basal cells and squamous cells.The superficial aspect of the tumor was composed of numerous keratinous cysts,large,round,and polygonal neoplastic cells with abundant vacuolated and granular eosinophilic cytoplasm.The tumor grew in a nest-like or alveolar pattern separated by delicate fibrovascular septa.The tumor cells were round or oval,with slightly eosinophilic cytoplasm,small heteromorphism of nucleus and rare mitosis.Immunohistochemically,all MACs showed staining with CK5/6.CK7,EMA and CEA staining occurred centrally in areas with glandular features.P63 was positive in the periglandular cells,but nega tive in the central cells.CK20 was negative.The Ki-67 proliferation index was less than 5%in the tissues.Conclusion MAC is a rare low-grade malignant adnexal carcinoma that related to pilar and eccrine differentiation with favorable prognosis.It has unique pathomorphological characteristics,which should be differentiated from desmoplastic trichoepithelioma,sclerotic basal cell carcinoma,syringoma,squamous cell carcinoma et al.
作者
梁国栋
孟亚飞
包海龙
朱林琳
LIANG Guodong;MENG Yafei;BAO Hailong;ZHU Linlin(Department of Pathology,Hulunbeier People's Hospital,Hulunbuir,Inner Mongolia,021008,China)
出处
《当代医学》
2021年第31期73-76,共4页
Contemporary Medicine
关键词
微囊性附属器癌
免疫组织化学
鉴别诊断
临床病理
Microcystic adnexal carcinoma
Immunohistochemistry
Differential diagnosis
Pathological characteristics
