恶性黑棘皮病、大疱性类天疱疮并食管癌1例  

A Case of Malignant Acanthosis Nigricans Accompanied with Esophageal Carcinoma and Bullous Pemphigoid

作　　者：罗斌华[1] 杨桂兰[1] 杜华[1] 

机构地区：[1]兰州军区兰州总医院皮肤科,甘肃兰州730050

出　　处：《中国皮肤性病学杂志》2015年第9期950-951,共2页The Chinese Journal of Dermatovenereology

摘　　要：患者男,80岁。周身色素沉着、灰褐色斑丘疹伴痒1年,水疱1周。斑块组织病理示:表皮角化过度,乳头瘤样增生,真皮浅层多量炎性细胞浸润。水疱组织病理示:表皮下形成大疱,疱内可见嗜酸性粒细胞、淋巴细胞、中性粒细胞。免疫荧光示:Ig G,Ig M,C3呈线状沉积。胃镜示:食管下端一菜花状隆起,表面粗糙不平,管腔狭窄。组织病理示:癌组织呈腺管状或巢团状,细胞核大深染;免疫组织化学结果:癌组织CK18(+),C-erb B-2(+)。诊断:恶性黑棘皮病,食管癌(腺癌),大疱性类天疱疮。A 80-year-old male presented with 1-year-history of generalized pigmentation and taupe maculopapule with itching, 1-week-history of blister. The histopathology of maculopapule showed hyperplastic epidermis, papillomatous hyperplasia and superficial dermal infiltration by many lymphocytes. The histopathology of blister showed subepidermal blister infiltrated by lymphocytes, eosinophilic granulocytes and netrophilic granulo- cytes. Immunofluorescence revealed linear deposition of IgG, IgM and C3. Endoscopy revealed a lower-esophageal cauliflower -like tumor with rough surface and lumenal stenosis. Histopathology showed carcinoma cells with large nucleus and hyperchromatism arranged in crypt-like or nest-like structures. Immunohistochemistry showed CK18 （ ＋ ）, C-erbB-2 （ ＋ ）. Diagnoses of malignant acanthosis nigricans, esophageal carcinoma （ adenocarcinoma） and bullous pemphigoid were made.

关 键 词：恶性 黑棘皮病 大疱性类天疱疮 食管癌 副肿瘤性皮肤病 

分 类 号：R758.6[医药卫生—皮肤病学与性病学]