螺旋腺瘤10例临床病理分析

Spiradenoma of sweat gland:a clinical and pathological analysis of ten cases

目的探讨螺旋腺瘤的临床病理特征、诊断及鉴别诊断。方法回顾性分析2012—2021年陕西省人民医院病理科10例螺旋腺瘤患者的临床病理资料,并进行相关文献复习。结果10例螺旋腺瘤患者中,男性6例,女性4例,中位年龄为51.5岁,皮损多发生于四肢和躯干,镜下表现为真皮内不与表皮相连、有包膜的肿瘤团块,可见核小、深染及细胞较大、淡染的两种肿瘤细胞,其他组织学形态包括3例见包膜侵犯,1例见鳞状细胞桑葚胚,1例肿瘤组织旁可见毛囊,1例合并圆柱瘤,3例可见血管扩张,4例肿瘤细胞条索间可见间质疏松水肿及淋巴管扩张,1例见少量中性粒细胞及嗜酸性粒细胞浸润。3例加做免疫组化,结果显示HCK、p63、SMA、S-100、CK7、CK8/18阳性表达,Ki-67增殖指数<5%,其中1例CEA阴性。结论螺旋腺瘤诊断依靠病理诊断,免疫组化辅助诊断,避免误诊。

Objective To investigate the clinical and pathological features,diagnosis and differential diagnosis of spiradenoma.Methods The clinicopathological features of 10 cases of spiradenoma colleceted in Shaanxi Provincial People’s Hospital from 2012 to 2021 were analyzed retrospectively,and relevant literatures were reviewed.Results The median age of 10 cases was 51.5 years,including 6 males and 5 females.The tumors occurred mostly on the extremities and trunk.Microscopically,the tumor mass with capsule was not connected with epidermis in the dermis,and there were two kinds of tumor cells:small cells with deep staining nucleus and large cells with light staining.Other histopathological features were observed:3 cases with capsular invasion,1 cases with squamous cell morula,1 case with hair follicles adjacent to tumor tissue,1 case with cylindroma,3 cases with vascular dilatation,4 cases with loose interstitial edema and lymphatic dilatation between tumor cell cords,and 1 case with infiltration of neutrophils and eosinophils.Immunohistochemical results of 3 cases showed these tumor cells were positive for HCK,P63,SMA,S-100,CK7,CK8/18 and Ki-67 index was about<5%.These cells did not express CEA in 1 case.Conclusion The diagnosis of spiradenoma depends on the pathological analysis and immunohistochemical staining to avoid misdiagnosis.