原发性皮肤黏液癌3例临床病理观察及文献复习
| 作者: |
1赵声春,
2徐德,
1何桂香,
1牟海,
1张莉英,
1黄倩
1 成都市青白江区人民医院病理科，成都 610300 2 攀枝花学院附属医院病理科，四川 攀枝花 617000 |
| 通讯: |
赵声春
Email: zschxy@163.com |
| DOI: | 10.3978/j.issn.2095-6959.2016.07.029 |
摘要
目的：探讨原发性皮肤黏液癌的临床病理学特点及预后。方法：通过临床资料总结、病理形态学观察、免疫表型分析，并复习文献资料。结果：皮肤原发性黏液癌直径0.3~15 cm不等，生长缓慢，病程常为数月至数十年。组织学上，表皮完整，肿瘤主要位于真皮层，并常累及皮下脂肪组织，大量黏液形成黏液湖，纤细的纤维将黏液湖分隔成多房性、蜂窝状。黏液湖中可见散在岛状、簇状、小腺样肿瘤上皮团。肿瘤细胞小，呈立方形，胞浆丰富，细胞核小，未见核分裂。免疫组化：癌细胞例1：CEA、EMA、ER、PR、P53、CK7、GCDFP-15(+)，TTF-1、S-100、CK20(−)。例2：CEA、EMA、P53、CK7、GCDFP-15(+)，ER、PR、TTF-1、S-100、CK20(−)，Ki-67低表达(1%~3%)。例3：CEA、EMA、CK7、GCDFP-15(+)，P53、ER、PR、TTF-1、S-100、CK20(−)，Ki67(+<10%)。结论：原发于皮肤的黏液癌少见，好发于老年男性的头面部，组织学上与转移性黏液癌鉴别困难，须结合临床及免疫组化标记排除转移癌后方可诊断。免疫组织化学多表达CK7、GCDFP-15、EMA、CEA，Ki67阳性率低<10%。治疗主要采用手术局部扩大切除肿瘤，预后较好。
关键词：
皮肤
黏液癌
免疫组织化学
鉴别诊断
预后
Clinicopathological observation and literature review of 3 cases of primary cutaneous mucinous carcinoma
CorrespondingAuthor: ZHAO Shengchun Email: zschxy@163.com
DOI: 10.3978/j.issn.2095-6959.2016.07.029
Abstract
Objective: To investigate the pathological characteristics and prognosis of primary cutaneous mucinous carcinoma (PCMC). Methods: Summarized the clinical data, observed the pathological morphology, analyzed the immune phenotype, and reviewed the literature. Results: The diameter of the PCMC ranging from 0.3-15 cm, grows slowly, and the course of the disease is usually several months to several decades. Histological features include: skin integrity and tumors mainly located within the dermis, often invaded the subcutaneous adipose tissue, mucus can form mucous lake, delicate fiber will mucous lake is divided into multi room, honeycomb. The mucous lake is visible in the scattered islands, clusters and small adenoid tumor cells. The tumor cells were small in size, in a cubic shape, with abundant cytoplasm and small nucleus. Immunohistochemical characteristics of cancer cells: case 1: CEA, EMA, ER, PR, P53, CK7, GCDFP-15(+), TTF-1, S-100, CK20(−); case 2: CEA, EMA, P53, CK7, GCDFP-15(+), ER, PR, TTF-1, S-100, CK20(−), Ki-67(1-3%); case 3: CEA, EMA, CK7, GCDFP-15(+), P53, ER, PR, TTF-1, S-100, CK20(−), Ki67(+<10%). Conclusion: PCMC is rare and occurs in the head and face of the elderly. Pathological identification of metastatic mucinous carcinoma and PCMC is often difficult and must be based on clinical and immunohistochemical markers to exclude metastatic mucinous carcinoma. Immunohistochemical features: CK7, GCDFP-15, EMA, CEA (+), Ki67 positive rate <10%. The main treatment is surgical resection of the tumor, and the prognosis is good.