角化棘皮瘤样皮脂腺腺瘤一例

Keratoacanthoma-like sebaceous adenoma:a case report

63岁男性患者,右侧鼻唇沟丘疹2个月。皮肤科情况:右鼻唇沟可见一黄色丘疹,呈半球形,直径约0.5 cm,中央有火山口样脐凹,可见血痂,边界清楚,有卷曲边缘。皮损组织病理示:部分表皮缺如,真皮中上部可见一肿瘤团块,界限欠清,无明显包膜,有多个分叶状结构与表皮相连,主要由基底样细胞及成熟或未成熟的皮脂腺细胞构成,团块周围有纤维包绕,但无明显收缩间隙及栅栏状排列的细胞。免疫组化染色示:MSH1、MSH2、MSH6、EMA、AR、CK、CK5/6均阳性,PMS2、D2-40局灶性阳性,CEA阴性,Ki-67约30%阳性。诊断:角化棘皮瘤样皮脂腺腺瘤。治疗予皮损手术切除。

A case of keratoacanthoma-like sebaceous adenoma is reported.The patient,63-year-old,male,had skin lesion on the right nasolabial groove for 2 months.Dermatologic exam:a yellow papule with a diameter about 0.5 cm located in the right nasolabial groove,with crater-like umbilicus in the center,visible scabs,clear boundary and curled edge.Histopathologic findings:a part of epidermis was absent,a tumor mass located in the middle and upper dermis,with unclear boundary and no obvious capsule,connected with epidermis by many lobulated structures,which were mainly composed of basaloid cells and mature or immature sebocytes.There were fibers around the mass,but had no obvious contraction gaps and palisade cells.Immunohistochemical results:MSH2(+),PMS2(+/-),MSH6(+),MLH1(+),CEA(-),EMA(+),AR(+),D2-40(focal+),CK(+),CK5/6(+).Diagnosis:keratoacanthoma-like sebaceous adenoma.The patient was treated with surgical resection.