41例皮肤基底细胞癌的临床病理及误诊分析

Analysis of Clinicpathological Features and Misdiagnosis of Basal Cell Carcinoma in Skin

目的:分析总结41例皮肤基底细胞癌的临床病理特点及误诊情况。方法:对41例皮肤基底细胞癌的临床及病理资料进行回顾性分析。结果:41例皮肤基底细胞癌中,发病年龄中位数为59岁(34～82岁),多发于头面部,共39例,占95.1%,通过组织病理检查,41例均证实为基底细胞癌。其中9例进行免疫组化标记示CK(+),S-100(-)。临床诊断为基底细胞癌24例,占58.5%,误诊为脂溢性角化4例,黑素细胞痣3例,鳞状细胞癌、黑素细胞瘤、寻常狼疮各2例,误诊为其他4例。结论:被误诊的皮肤基底细胞癌患者大多数年龄较大,病程缓慢,临床表现不典型。尽早行组织病理检查,并结合免疫组化标记进行识别,可提高皮肤基底细胞癌的诊断准确率。

Objective：To study the clinical - pathological features of basal cell carcinoma （BCC） and causes underneath misdiagnosis. Methods：41 cases, previous dignosed as BCC and other diseases, were retrospectively analyzed. Results：The median age of patients in this group were 59 years old（34 years old - 82 years old） , the most frequent sites were the scalp and the face（39 cases, 95.1% ）. With the help of pathological examinations, all of these 41 cases were confirmed the diagnosis of BCC. Immunohistochemical technique was performed in 9 cases and showed that CK（ ＋ ）, S - 100（ - ）. Among these 41 cases, 4 cases were previously diagnosed as seborrheic keratosis, 3 cases as melanocytic nevus, 2 cases as squamous cell carcinoma （SCC）, 2 cases as malignant melanoma, 2 cases as lupus vulgaris and 4 cases as other diseases. Conclusion ： Under the situation of patient＇s senior age, slow progression of the disease course and the non -typical clinical presentations, BCC might be misdiagnosed. Pathological examination is important to improve accuracy of diagnosis. Immunohistochemical technique is essential for the differential diagnosis among BCC and other diseases.