角化棘皮瘤63例临床表现及组织病理分析

Clinical and Pathological Analysis of 63 Cases of Keratoacanthoma

目的探讨角化棘皮瘤的临床及组织病理学特点。方法回顾分析2011年1月-2014年8月本科诊治的63例角化棘皮瘤患者的临床及组织病理资料。结果 63例角化棘皮瘤均为单发型皮损,男∶女=0.85∶1。49例(77.78%)>50岁。成熟期角化棘皮瘤48例。4例符合消退期角化棘皮瘤病理改变,其中1例出现典型皮角。6例符合早期角化棘皮瘤病理改变。5例细胞异型性比较明显,其中2例病理性核分裂较多,呈浸润性生长,该2例术后予光动力疗法治疗。所有病例随访至今,均未见复发。结论角化棘皮瘤临床上容易被误诊,需结合临床表现与组织病理检查确诊。单发型皮损建议手术切除治疗,必要时可行光动力疗法治疗。

Objective To analyze the clinical and histological characteristics of keratoacanthoma （KA）. Methods Retrospective analysis was performed in 63 cases of keratoacanthoma diagnosed in the department of derma- tology of Daping Hospital, Third Military Medical University, from January 20ll to August 2014. Results Isolated nodule occurred in all 63 cases, with a male to female ratio of 0.85：1. 77.78% of cases were over 50 years old. 48 cases were mature keratoacanthoma. Four cases showed pathological changes of involuting keratoacanthoma, including 1 case of typical cutaneous horn. Six patients showed early KA pathology. Marked atypia cells were observed in 5 cases, 2 of which showed prominent pathological mitosis and infiltrative growth. The latter 2 patients were treated with photodynamic therapy after surgery. All patients were followed up until present with no recurrence. Conclusion Clinically keratoacanthoma can be easily misdiagnosed. A diagnosis should be made based on both clinical and pathological features. Surgical excision is rec- ommended for solitary KA, and photodynamic therapy could be used if it becomes necessary.