皮肤混合瘤17例临床及组织病理分析

Clinical and pathological analysis of 17 cases of mixed tumor of skin

目的探讨皮肤混合瘤临床、组织病理特点及鉴别诊断。方法回顾性归纳分析华中科技大学同济医学院附属协和医院皮肤科1999—2017年17例皮肤混合瘤患者的临床病理资料。结果17例患者中14例向顶泌汗腺分化,其中10例有明显的管泡状结构,9例有导管结构,4例见角质囊肿及毛乳头结构;17例患者均见黏液样、纤维化间质,间质中均见浆细胞样细胞、多角形细胞、梭形细胞,1例出现软骨样间质;初诊误诊15例,误诊率为88.24%。结论皮肤混合瘤虽然组织病理学上具有特征性,但临床误诊率极高,应引起临床医生的重视。

Objective To investigative the clinical,pathologic features and differential diagnosis of skin mixed tumor.Methods The clinical manifestations,relevant data of misdiagnosis,pathologic characteristics of 17 patients with skin mixed tumors from our department from 1999-2017 were analyzed retrospectively.Results The histological findings shown that 14 cases had differentiation toward apocrine glands,10 cases had tubuli-vesicular structure,9 cases had tubular structure,4 cases had keratocysts and hair papilla structure.All of the 17 cases had myxoid and fibrotic stroma,with plasmacytoid cells,polygonal cells and spindle cells infiltrated interstitially,and chondroid stroma was revealed in one case.Initially 15 patients were misdiagnosed(the rate of misdiagnosis was 88.24%).Conclusion Although mixed tumor of the skin has specific pathological features,but with very high clinical misdiagnostic rate,which should be paid attention to by the clinicians.