皮肤基底细胞癌与毛母细胞瘤临床病理比较分析

Comparative analysis of clinicopathological features of cutaneous basal cell carcinoma and trichoblastom

目的探讨皮肤基底细胞癌(BCC)与毛母细胞瘤(TBL)的临床病理特征和鉴别诊断要点。方法分析攀钢集团总医院病理科2013年7月-2019年8月诊断的29例基底细胞癌的临床病理资料、组织形态学特征、免疫组化标记,并与9例毛母细胞瘤相比较。结果二者均好发于头面部,BCC24例,TBL8例;镜下二者均由大小不一基底样细胞巢组成,周边细胞栅栏状排列,均可见有丝分裂象和凋亡细胞。BCC常有溃疡和显著的收缩间隙以及黏蛋白沉积,TBL常呈分叶状排列,乳头间质伴毛球形成为特征性表现;BCC中20例CD10瘤细胞阳性,7例部分阳性,癌周间质阴性,18例BCL2阳性,5例部分阳性;TBL中9例瘤细胞CD10阴性,癌周间质阳性,6例BCL2阴性,3例部分阳性。结论BCC与TBL在组织形态学上有相似之处,易误诊,细致的组织形态观察和免疫组化染色有助于二者鉴别。

Objective To explore the clinicopathological features and the key points of differential diagnosis of cutaneous basal cell carcinoma(BCC)and trichoblastom(TBL).Methods The clinicopathological data,histomorphological characteristics and immunohistochemical markers of 29 cases of basal cell carcinoma diagnosed from July 2013 to August 2019 inpathology department of general hospital of Pangang were analyzed,and compared with 9 cases of trichoblastom.Results Both of them were located in the head and face,with 24 cases of BCC and 8 cases of TBL.Both of them were composed of different basal-like cell nests with different sizes,and peripheral cells were arranged in a fenced manner,all of which could be seen as mitogens and apoptotic cells.BCC often has ulcerations and/or significant contraction clearances and mucin deposition,and TBL in a lobular arrangement,papal interstitial and hair spherical were the characteristic manifestations.In BCC,20 cases were positive in CD10 tumor cells,7 cases were partially positive and negative in pericancerous stroma,18 cases were positive in BCL2,and 5 cases were partially positive.In TBL,9 cases were negative in CD10 tumor cells,positive in pericancerous stroma,6 cases were negative in BCL2,and 3 cases were partially positive.Conclusions BCC and TBL have similarities in organizational morphology and are easy to be misdiagnosed.Therefore,the meticulous tissue morphology observation and immunohistochemical staining could help to identify them.