甲乳头状瘤5例临床及组织病理分析

Clinicopathologic analysis of five cases of onychopapilloma

目的:探讨甲乳头状瘤的临床、皮肤镜、组织病理特征及鉴别诊断。方法:对2017年5月—2019年5月该院确诊的5例甲乳头状瘤患者的临床、皮肤镜及组织病理特征进行回顾性分析。结果:5例患者中男3例,女2例,年龄为22~56岁,病程为6个月~6年。5例患者肿瘤均位于手指甲,其中4例表现为纵行黑甲,1例表现为裂片形出血。5例均见远端甲下角化。4例见远端甲板分离。本组患者组织病理均表现为甲床的棘层肥厚或乳头瘤样增生,局部非对称性甲板下方层状角化过度,可见甲母质样化生,角质团块内见出血,其中1例甲床上皮可见多核巨细胞。结论:甲乳头状瘤相对罕见,具有独特的临床及组织病理学特点,皮肤镜显示远端甲下角化性团块有助于诊断。

Objective:To investigate the clinical, dermoscopic and pathological features of onychopapilloma, and the differential diagnosis of it. Methods:The clinical and pathological data of five onychopapilloma cases(three males and two females,aged from 22 to 56 years) diagnosed in the Department of Dermatology of Xijing Hospital from May 2017 to May 2019 were retrospectively analyzed. Results:The course of disease of the five patients ranged from half a year to six years. The tumors were all located in the fingernails, with four cases showing longitudinal melanonychia, and one splinter haemorrhage. Distal fissuring was found in four cases. The histopathological features were acanthosis and papillomatosis of the nail bed with a local keratogenous zone. Multinucleate cells could be seen in one case. Conclusions:Onychopapilloma is a distinctive clinicopathologic entity. The small subungual keratotic mass on the free edge of the nail plate detected by dermoscopy could provide a clue for the diagnosis of onychopapilloma.