消化道外基底细胞样鳞状细胞癌4例临床病理分析

Basaloid squamous cell carcinomas outside alimentary tract:a clinicopathological analysis of four cases

目的对基底细胞样鳞状细胞癌(BSCC)的临床病理特点、组织起源、诊断与鉴别诊断等进行初步探讨。方法对4例消化道外BSCC做常规石蜡切片,行HE和免疫组化染色。结果 4例中男性1例,女性3例,发病年龄分别为26、58,66和70岁。4例肿瘤分别位于右下鼻道和右上颌窦腔、腭部正中硬软腭交界处、右上臂皮肤及头顶部皮肤。结论 BSCC常呈浸润性生长,肿瘤表面多有溃疡形成,镜下瘤细胞小,呈基底细胞样,排列成实性巢状及条索状,在瘤细胞巢周围的细胞排列成栅栏状,在中央可见特征性的粉刺样坏死。2例BSCC中可见局灶性鳞状细胞分化及角化。免疫组化瘤细胞上皮及肌上皮标记阳性。BSCC须与多种其他恶性肿瘤相鉴别。

Objective To explore the clinical pathological features,histogenesis,diagnosis and differential diagnosis of the basaloid squamous cell carcinoma（BSCC）.Methods Four cases of BSCC were studied by using of paraffin section,HE staining and immunohistochemical staining.Results Four cases of BSCC located at right nasi meatus inferior and the right maxillary sinus cavity,the junction of hard and soft palate of the midpalatal suture,skin of right upper arm and the scalp,respectively.Of the 4 cases,1 were male and 3 were female.The ages of the four patients were 26,58,66 and 70 years,respectively.Conclusion Macroscopically,the characteristics of BSCC are frequently invading the surrounding tissues and have the ulcers at the surface of the tumors.Microscopically,the features of the tumors are that the small and basaloid cells arrange in solid nests and cords,the cells around the nests arrange in palisade,and cells in the center of the nest often appear the comedo-like necrosis.In 2 cases,the tumor cells are accompanied with local squamous cell differentiation and keratinization.By immunohistochemical stain,the tumor cells express the epithelial and myoepithelial markers.BSCC should be differentiated from many other malignant tumors.