皮脂腺痣并发小汗腺汗孔癌1例

Sebaceous Nevus with Eccrine Porocarcinoma:a case report

患者男,39岁。左侧头皮、面部丘疹、结节、斑块39年,部分菜花样隆起1年。皮损组织病理检查:面部前额斑块病理片显示表皮角化过度,乳头瘤样增生,真皮层皮脂腺明显增生。菜花样增生物病理片示真皮可见一个或多个上皮肿瘤细胞团,呈巢索状;肿瘤细胞团内见多角形、核位于细胞中央的的鳞状细胞样瘤细胞和含丰富的糖原且细胞膜清楚的浅染瘤细胞,核分裂相多,有病理性核分裂;瘤细胞浸润真皮及皮下,可见局灶有导管分化。免疫组化提示肿瘤结节混合性CK(细胞角蛋白)阳性,肿瘤内导管结构EMA(上皮膜抗原)强阳性,PAS染色可见胞浆内糖原染色阳性。根据临床资料、组织病理及免疫组化诊断为皮脂腺痣并发小汗腺汗孔癌。

The patient is a male, 39 years old. Papules, node and plaques are found on his left scalp and face for 39 years,and some cauliflower-like hyperplasia exists for 1 year. After histopathological examination, the pathologic slice of the facial plaques on his forehead appears hyperkeratosis, hyperplasia of mammilla tumor also occurs, sebaceous gland at dermis layer appears obviously hyperplastic. Cauliflower-like hyperplasia pathological slice shows that the one or many irregular epithelial tumor cell grown in curls in the shape of nest and chain. And the tumor cells are mainly those polygonal, karyon-centered, and squamous tumor cells and light staining tumor ceils with rich glycogen and clear cell membrane. Moreover, karyokinesis is discovered with pathological ones. Tumor cell has invaded the dermis subcutaneously. Catheter is observed partially. Immunohistochemistry suggests the admixture of tumor node, positive CK, strong positive EMA of the tube structure in side the tumor, PAS staining showed positive staining of intracytoplasmic glycogen. In accordance with the clinical data, pathological changes and immunohistochemistry, it is diagnoses that the patient catches Sebaceous Nevus along with Eccrine Porocarcinoma.