原发性皮肤黏液癌2例临床病理观察  

Primary cutaneous mucinous carcinoma:a clinicopathologic study of 2 cases

作　　者：宋红杰[1] 刘冲[2] 曾铮[2] 马恒辉[2] 周航波[2] 王海[2] 石群立[2] 

机构地区：[1]海门市人民医院病理科,江苏海门226100 [2]南京军区南京总医院病理科,南京210002

出　　处：《诊断病理学杂志》2011年第6期443-446,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨原发性皮肤黏液癌的临床病理学特点及预后。方法应用光镜观察、免疫组化等方法对2例原发性皮肤黏液癌进行分析,并复习相关文献。结果皮肤原发性黏液癌生长缓慢,病程常为数年甚至数十年。组织学上,肿瘤主要位于真皮层,并常累及皮下脂肪组织,癌细胞团块呈岛状漂浮在淡染的黏蛋白湖中,周围由纤细的纤维将其分隔;癌细胞为立方形、圆形或卵圆形,胞质丰富,淡红染,细胞核圆形或卵圆形,居中,核分裂象少见。免疫组化:癌细胞CK7、ER、PR、CEA和GCDFP-15(+),CK20、CDX-2、CA125,TTF1、c-erbB-2、PSA和villin均(-),Ki-67低表达(通常<5%)。结论原发于皮肤的黏液癌罕见,组织学上与转移性黏液癌鉴别困难,须结合临床及免疫组化标记排除转移癌后方可诊断。该肿瘤恶性度低,治疗主要采用手术切除肿瘤,预后较好。Purpose To investigate the clinicopathological feature and immunophenotype of primary cutaneous mucinous carcinoma（PCMC）.Methods Two cases of PCMC were studied by microscopic observation and immunohistochemical staining,with a review of the related literatures.Results PCMC was a slow-growing tumor,often growing few years or few decades.Histologically,the tumor located in corium,and often invaded in the fat tissue.The definitive histopathology showed small cellular nests of adenocarcinoma lying in pools of extracellular mucin that were separated by fibrocollagenous septa.The immunohistochemical staining revealed that the tumor cells were positive for CK7,estrogen receptor（ER）,and progesterone receptor（PR）,CEA and gross cystic disease fluid protein（GCDFP-15）,very low positive for Ki-67（5%） and negative for CK20,CDX-2,CA125,TTF1,c-erbB-2,PSA and villin.Conclusion PCMC is very rare,and it is difficult to identify the metastases or primary tumor in histomorphology.We must eliminate the possibility of metastases before the diagnosis of PCMC.The tumor is low malignant,and local excision should be required only.The prognosis is not bad.

关 键 词：皮肤 黏液癌 免疫组化 鉴别诊断 预后 

分 类 号：R739.5[医药卫生—肿瘤]