Merkel细胞癌2例报道及文献复习

Merkel cell carcinoma: a report of two cases and review of the literature

目的 探讨皮肤Merkel细胞癌的临床病理特点、诊断和预后。方法 对 2例Merkel细胞癌进行光镜和免疫组化观察并结合文献进行分析。结果 瘤细胞圆形、卵圆形 ,胞质少呈裸核状 ,核分裂象多 ;瘤细胞呈弥漫分布或巢索状排列。免疫组化标记CK、NF、NSE和Syn(+)。 1例切除后复发。结论 Merkel细胞癌是一种高度恶性的皮肤原发性神经内分泌癌。病理诊断依赖于组织学、免疫组化和电镜观察 ,免疫组化在该病的诊断和鉴别诊断中具有重要价值。局部扩大切除加放疗有控制复发的作用。有转移的患者可考虑化疗 。

Objective To study the clinicopathology, diagnosis and prognosis of Merkel cell carcinoma Methods Light microscopy and immunohistochemical (IHC)staining were used with review of the literature Results The tumor cells were round or oval in shape with little cytoplasm and nearly nude nuclei which had a high frequency of mitoses The arrangement of the cells was diffuse or in sheet like structure. IHC staining for oytokeratin (CK), neurofilament(NF), neurospecific enolase(NSE), and synaptosin(SYN)were positive in most cells One of the two cases in this study had recurrence after surgical removal of the tumor Conclusions Merkel cell carcinoma is a high grade and primary neuroendocrine carcinoma of the skin The pathological diagnosis depends on histology, IHC and the observation with electronic microscopy IHC plays an important role in the diagnosis and the differential diagnosis from other diseases Local expanded removal and radiotherapy may help to control the recurrence Chemicotherapy could be taken into account in the patient whose neoplasm has metastasized, but the efficiency is not satisfied in the later stage