皮肤螺旋腺瘤25例临床病理分析  

CHnicopathologic analysis of spiradenoma： 25 case reports

作　　者：李丽娟[1] 柳剑英[1] 苏静[1] 高菲[1] 郑杰[1] 廖松林[1] 

机构地区：[1]北京大学医学部基础医学院病理学系、北京大学第三医院病理科,100191

出　　处：《中华皮肤科杂志》2015年第7期455-458,共4页Chinese Journal of Dermatology

摘　　要：目的对皮肤螺旋腺瘤及其恶性转化病例进行分析。方法回顾性分析25例皮肤螺旋腺瘤患者的临床病理资料，结合免疫组化及文献复习，总结其临床病理学特征。结果25例皮肤螺旋腺瘤的诊断年龄平均为40岁，24例（96％）为后天性、单发性病变，以四肢最为常见。23例为良性皮肤螺旋腺瘤，组织学形态多样，其中15例（65％）为单纯性皮肤螺旋腺瘤，8例（35％）为螺旋圆柱腺瘤；可见多少不一的分裂象；免疫组化显示有上皮和肌上皮分化。2例皮肤螺旋腺瘤分别恶变为低级别基底细胞腺癌和高级别腺癌，恶变区域淋巴细胞显著减少或消失。肿瘤大小0．2～3cm，23例良性病变中，20例（87％）的直径〈2em，3例≥2em；2例恶性病变直径均超过2cm。结论皮肤螺旋腺瘤是一种缺乏临床特异性但组织学特征鲜明的肿瘤，大多数皮肤螺旋腺瘤呈良性临床经过，对于病程较长且体积较大的皮肤螺旋腺瘤要注意恶变的可能性。Objective -To analyze clinicopathologic features and malignant transformation of spiradenoma （SA）. Methods Clinicopathologic data on 25 cases of SA were retrospectively analyzed. An immunohistochemical study was conducted on 5 of the 25 patients. Clinicopathologic features of SA were summarized based on clinicopathologic data, immunohistochemical results and relevant literature. Results The average age of these patients was 40 years. Lesions were acquired and solitary in 24 cases （96%, 24/25）, and occurred most frequently in the extremities. The diameter of tumors was less than 2 cm in 20 cases （87%, 20/23）. Twenty-three cases were benign SA with various histological manifestations, including 15 cases （65%, 15/23） of typical SA, 8 cases （35%, 8/23） of cylindroma. Varying numbers of mitotic figures were observed in different cases. The immunohistochemical study showed epithelial and myoepithelial differentiation. Two cases of SA experienced malignant transformation into poorlydifferentiated basal cell adenocarcinoma and well-differentiated adenocarcinoma respectively. Lymphocytes decreased significantly in number or disappeared in the malignant area, and both the malignant tumors exceeded 2 cm in diameter. Conclusions SA is a kind of neoplasm with distinct histological characteristics and nonspecific clinical manifestations. Most SA cases have a benign clinical course, but malignant transformation should be considered in some cases with long- term clinical course and large size.

关 键 词：病理学 临床 螺旋腺瘤 螺旋腺癌 

分 类 号：R739.5[医药卫生—肿瘤]