皮脂腺痣并发鳞状细胞癌

Nevus Sebaceous combined with squamous cell carcinoma

报告1例皮脂腺痣并发鳞状细胞癌。患者男,28岁。右颊部疣状增生性斑块28年,原有皮损上缘新发结节并发溃疡2周。皮肤科检查:右颊部一纵向淡黄色隆起性斑块,表面呈疣状,无毛发,质地坚实。皮损上缘见一淡红色半球形结节。结节质地坚实,触之稍有浸润感,结节顶端呈火山口样浅溃疡。组织病理学检查:结节周边表皮疣状增生,真皮浅层大量成熟皮脂腺小叶。肿瘤完全由不典型的梭形细胞构成,束状及弥散状排列,浸润性生长。肿瘤细胞梭形,泡状核,核分裂象多见。免疫组化染色:AE1/AE3(+),角蛋白(CK)5/6(+),CK7(+),CAM5.2(+),波形蛋白(vimentin)(+),CD31(-),CD34(-),S-100蛋白(-),HMB45(-),A103(-),上皮膜抗原(EMA)(-),结蛋白(desmin)(-),平滑肌肌动蛋白(SMA)(-),钙桥(caldesmon)(-),KP-1(-),Fas(+/-),Ki67(+,30%)。

A case of nevus sebaceous combined with squamous cell carcinoma is reported. A 28-year-old man presented with a 28-year-history of yellow plaque on his right cheek and a new onset neoplasm on the plaque for 2 weeks. Clinical examination showed a yellow alopecic plaque which had a rough surface on his right cheek. On the upper part of the plaque there was a hemispheric, dome-shaped, red nodule in which there was a smooth crater with crust on the surface. Histological examination showed a verrucous appearance of epidermis and hyperplasia of sebaceous glands was adjacent to the tumor. The tumor was totally composed of invasive, spindle shape cells, which arranged in fascicles or irregularly. Mitotic figures were easily identified. Nuclear pleomorphism was minimal. Immunohistochemistry showed that the expression of AE1/AE3, CK5/6, CKT, CAM5.2 and vimentin was positive, and CD31, CD34, S-100, HMB45, A103, EMA, desmin, SMA, caldesmon, KP-1 negative, Fas and Ki67 was partially positive. Nevus sebaceous combined with spindle-cell squamous cell carcinoma was diagnosed.