增殖性外毛根鞘囊肿的临床病理分析

Clinicopatholgical features of proliferating trichilemmal cyst

目的探讨增殖性外毛根鞘囊肿(proliferating trichilemmal cyst,PTC)的临床病理学特征、鉴别诊断及组织发生.方法对9例良性、1例恶性和1例发生间变的PTC病例进行临床资料分析、光镜观察并复习相关文献.结果 9例良性PTC,女性8例,男性1例,年龄38～78岁,平均病程7.8年;2例恶性PTC年龄分别为82岁和47岁,平均病程为5年.良、恶性PTC共同特征为增生的鳞状上皮组成的瘤团中央突然角化,恶性PTC皮损迅速扩大,病理特征包括较多核分裂象、细胞异型性以及瘤组织侵犯周围正常组织.结论良、恶性PTC的区分应该依靠临床和病理学特征,鉴别诊断包括皮肤鳞状细胞癌和外毛根鞘癌等.

Purpose To investigate the clinicopathological features, differential diagnosis and histogenesis of proliferating trichilemreal cyst （PTC）. Methods The data of 11 cases of PTC, including nine benign, one malignant and one anaplastic case, were analyzed. In addition, the related literature was reviewed. Results The features of both benign and malignant PTCs were in common, including a central area of abrupt keratinization and areas formed by hyperplastic squamous epithelium. If the lesion became increasingly large, invading to the adjacent tissue, along with a high mitotic rate, atypical mitosis and severe nuclear pleomorphism, the diagnosis of malignant transformation should be considered. Conclusions Based on the pathological and clinical features, malignant and benign PTCs could be distinguished from each other. Differential diagnosis of PTC might include squamous cell carcinoma and trichilemmal carcinoma.