眼睑皮脂腺癌7例临床病理分析  

Sebaceous carcinoma of the eyelids:a clinicopathological study of 7 cases

作　　者：崔娇娇 夏和顺 杨赤兵 Cui Jiaojiao;Xia Heshun;Yang Chibing(Department of Pathology,Wuhan Lanwei Medical Laboratory Co.,Ltd,Wuhɑn 430035,China;Department of Pathology,Geriatric Hospital Affiliated to Wuhan University of Science and Technology)

机构地区：[1]武汉兰卫医学检验实验室病理科,武汉430035 [2]武汉科技大学附属老年病医院病理科

出　　处：《实用医技杂志》2024年第2期128-130,I0002,共4页Journal of Practical Medical Techniques

摘　　要：目的分析眼睑皮脂腺癌的临床病理特征、免疫组织化学表达、诊断与鉴别诊断、治疗及预后。方法结合文献对7例眼睑皮脂腺癌的临床表现、组织形态、免疫组织化学及治疗与预后进行探讨。结果眼睑皮脂腺癌7例中男性3例,女性4例,年龄50~84岁,中位年龄67岁。镜下肿瘤呈不规则小叶状、巢团状排列,可伴有粉刺样坏死,根据细胞分化程度分为高分化、中分化和低分化。分化好的皮脂细胞大而淡染,圆形或多边形,具有泡状胞质及凹陷的核,可见核仁;分化差的细胞可似鳞状细胞、基底细胞和梭形细胞。免疫组织化学:广谱细胞角蛋白(PCK)、上皮膜抗原(EMA)、P63、细胞角蛋白5/6(CK5/6)和上皮细胞特异性蛋白(BerEP4)(+),癌胚抗原(CEA)和雄激素受体AR(-)。结论眼睑皮脂腺癌临床少见,容易误诊,需与鳞状细胞癌、基底细胞癌等相鉴别。免疫组织化学结合形态学有助于皮脂腺癌的诊断与鉴别诊断。Objective To study the clinicopathologic features,immunohistochemical staining,diagnosis and differential diagnosis,treatment and prognosis in sebaceous carcinoma(SC)of the eyelids.Methods The clini-cal manifestations,histopathological features,immunohistochemisty,treatment and prognosis were analyzed in 7 cases of SC with review of the literature.Results The patients included 3 males and 4 females,with an average age of 67 years old(ranged from 50 to 84 years old).Microscopically,the tumor cells arranged in a infiltrated lobu-lar or nest pattern,some with comedo necrosis.According to the degree of cell differentiation,it can be divided into high differentiation,medium differentiation,and low differentiation.Well differentiated sebocytes are round or polygonal large pale cells,with multivacuolated or bubbly cytoplasm and indentationed nuclei,nucleolis are visible;while poorly differentiated cells can resemble squamous cells,basal cells,and spindle cells.Immunohistochemical-ly,in all cases,PCK、EMA、P63、CK5/6 and BerEP4 are positive,CEA and AR are negative.Conclusion SC is rare and often misdiagnosed with squamous cell carcinoma or basal cell carcinoma.However,based on the typical histopathologic features and immunohistochemical reactions,the diagnosis can be more accurate.

关 键 词：皮脂腺肿瘤 眼睑 诊断 鉴别 免疫组织化学 

分 类 号：R739.7[医药卫生—肿瘤]