鼻部巨大角化棘皮瘤1例

A Case of Giant Nasal Keratoacanthoma

患者男,39岁。右侧鼻腔新生物3月余,鼻背肿物1月。查体见鼻背偏右类圆柱样新生物,直径约4.0cm,高约3.0cm,顶端中央形成"火山口"样溃疡,边缘见角化物,右侧鼻腔半颗花生米大小新生物,表面粗糙,质脆。鼻窦CT及电子鼻咽喉镜检查示:鼻腔肿物主要位于右侧鼻阈,半颗花生米大小,颈部淋巴结彩色超声未见异常。术中切除物组织病理示:肿瘤团块呈半球形隆出皮肤表面,中央火山口样充满角质物,瘤体由较大、淡染的角质形成细胞组成,两侧的上皮细胞成抱球状,局部基底部见浸润生长的肿瘤细胞,瘤体下方真皮浅层内密集淋巴细胞为主的炎症细胞浸润。诊断:角化棘皮瘤。

A 39-year-old male presented with neoplasm in right nasal cavity for more than 3 months,and a month history of neoplasm on the nasal dorsum for 1 month.Medical examination showed neoplasm on the right nasal dorsum,diameter was 4cm and the height was 3cm,which surface was covered with ulcer like a crater.A small neoplasm about half of pignut,with roughness of the surface and brittle character could be seen in right nasal cavity.Nasal CT and electron-nasopharyngo laryngoscope showed neoplasm in the right nasal cavity,cervical lymph ultrasounde was normal.Histopathological examination showed hemispherical tumor protruding from the skin surface,crater-like full of horny material on the central.The tumor was formed of large,light stained keratinocytes.Either side of epithelial cells were held into spherical,and the growth of tumor cells could be seen on local infiltration of the base.The main inflammatory cells were dense lymphocyte in the dermis shallow below the tumor.The diagnosis was keratoacanthoma.