皮肤Merkel细胞癌临床病理分析及文献复习

Clinicopathological analysis of cutaneous Merkel cell carcinoma and literature review

回顾性分析1例皮肤Merkel细胞癌患者的病史、肿瘤组织形态学特征及免疫组织化学表达情况,并复习相关文献。患者为老年男性,表现为皮肤孤立无痛结节,镜下肿瘤位于真皮层,瘤细胞呈片状及巢状分布,大小相对一致,嗜碱性,核质比高。免疫组织化学上皮及神经内分泌标志阳性,CK20胞质逗点状阳性,TTF-1,CD117,CD68,LCA均为阴性。Merkel细胞癌是皮肤原发的高度侵袭性神经内分泌肿瘤(amine precursor uptake and decarboxylation,APUD)肿瘤,需与皮肤转移性肺小细胞癌、恶性黑色素瘤及淋巴瘤等疾病进行鉴别。

The history, histomorphological features and immunohistochemical expression of 1 cases of cutaneous Merkel cell carcinoma was retrospectively analyzed, and reviewed the relevant literatures. This patient was an elderly men, manifested as a skin isolated painless nodule, tumor located in the dermis, oncocytes were flake and nests, relatively uniform in size, basophilic, karyoplasmic ratio under the microscope. Immunohistochemistry epithelia and neuroendocrine markers were positive, the positive expression of CK20 was cytoplasmic comma, and TTF-1, CD117, CD68 and LCA were negative. Merkel cell carcinoma is a highly aggressive amine precursor uptake and decarboxylation（APUD） of the skin. It is necessary to identify diseases such as metastatic pulmonary small cell carcinoma, malignant melanoma and lymphoma.