摘要
目的探讨2例Merkel细胞癌(MCC)的临床表现、病理特征及免疫表型。方法收集2例MCC细胞癌患者的临床资料,对其临床及病理进行分析,2例患者均采取肿瘤扩大手术切除治疗,术后进行化疗,对2例患者进行随访,观察预后情况。结果2例患者均为女性,年龄分别为63岁和85岁,发病部位1例位于左唇部,1例为原发病灶不明的腹股沟肿块。镜下见2例肿瘤位于真皮或皮下组织,未侵及表皮,瘤细胞弥漫分布,或呈小梁状及巢状分布,肿瘤组织细胞形态单一,胞质少,核圆形或椭圆形,核膜清楚,染色质细尘状。免疫组化染色显示上皮及神经内分泌标记阳性,其中CK20及PCK均呈特征的核旁点状阳性。2例患者均进行随访,例1术后9个月出现全身转移,于2019年1月死亡;例2术后3个月出现肺转移,未发现皮肤暴露部位隐匿的原发病变,于2020年5月死亡。结论MCC临床主要发生于老年患者,多见于阳光暴露部位皮肤,结合组织形态学和免疫组化染色特征有助于病理诊断。
Objective To explore the clinical manifestations,pathological features and immunophenotypes of Merkel cell carcinoma(MCC).Methods The clinical data of 2 cases of MCC cell carcinoma were collected,and their clinical and pathological data were analyzed.Two patients were treated with extended surgical resection of tumors,chemotherapy was performed after surgery,and two patients were followed up to observe the prognosis.Results Two patients were female,the ages were 85 and 63 years;one case was on the left lip,and one was a groin mass with an unknown primary lesion.Under microscope,2 cases of tumors were located in the dermis or subcutaneous tissue,and did not invade the epidermis,tumor cells were diffusely distributed,or distributed in trabecular and nested patterns;tumor cells had a single shape,few cytoplasm,round or oval nuclei,clear nuclear membrane,and fine dust-like chromatin.Immunohistochemical staining showed positive expression of epithelial and neuroendocrine markers in the tumor cells,of which CK20 and PCK were characteristic paranuclear punctate positives.Both patients were followed up.Case 1 developed systemic metastasis 9 months after surgery and died in January 2019;Case 2 developed lung metastasis 3 months after the operation,and no primary lesions hidden in the exposed parts of the skin were found,and died in May 2020.Conclusion MCC occurs mainly in elderly patients,and it is more commonly found in the skin of sun-exposed areas;the combination of histomorphology and immunohistochemical staining is helpful for pathological diagnosis.
作者
沈靖
芦华莉
刘德纯
SHEN Jing;LU Hua-li;LIU De-chun(Department of Pathology,Bengbu Third People’s Hospital,Bengbu 233000,China;Bengbu Lanwei Medical Laboratory,Bengbu 233000,China)
出处
《诊断病理学杂志》
2022年第7期610-613,共4页
Chinese Journal of Diagnostic Pathology
关键词
MERKEL细胞癌
临床病理
免疫组化
Merkel cell carcinoma
Clinical pathology
Immunohistochemistry
