CAJ | 학술논문

报告1例乳头状汗管囊腺癌.患者男,76岁.下腹部丘疹缓慢增大30余年,红肿、破溃1个月余.皮肤科检查:下腹部一约2 cm×2 cm肿块,类圆形,鲜红色,表面湿润,有较多血性黏液样渗出物,周围红肿,触诊质地稍硬.皮损组织病理检查:肿块表浅部为与表皮相连并开口于表皮的乳头状结构,乳头状结构衬以2层上皮样细胞,内层为胞质稀少、核呈卵圆形且深染的小细胞,外层为胞质丰富、嗜酸性、核大、空泡状的高柱状细胞,可见顶浆分泌;间质中有大量浆细胞.肿块深部为与表浅部相连续、大小不一的肿瘤细胞团块,肿瘤细胞胞质丰富、嗜酸性、核大、空泡状.肿瘤内可见核大、深染的异形细胞和病理性核分裂象.免疫组化染色:肿瘤细胞强阳性表达泛细胞角蛋白(pan-CK)和上皮膜抗原(EMA),部分表达巨囊病性液体蛋白-15(GCDFP-15),而不表达癌胚抗原(CEA)和S-100蛋白.诊断:乳头状汗管囊腺癌.
보고1례유두상한관낭선암.환자남,76세.하복부구진완만증대30여년,홍종、파궤1개월여.피부과검사:하복부일약2 cm×2 cm종괴,류원형,선홍색,표면습윤,유교다혈성점액양삼출물,주위홍종,촉진질지초경.피손조직병리검사:종괴표천부위여표피상련병개구우표피적유두상결구,유두상결구츤이2층상피양세포,내층위포질희소、핵정란원형차심염적소세포,외층위포질봉부、기산성、핵대、공포상적고주상세포,가견정장분비;간질중유대량장세포.종괴심부위여표천부상련속、대소불일적종류세포단괴,종류세포포질봉부、기산성、핵대、공포상.종류내가견핵대、심염적이형세포화병이성핵분렬상.면역조화염색:종류세포강양성표체범세포각단백(pan-CK)화상피막항원(EMA),부분표체거낭병성액체단백-15(GCDFP-15),이불표체암배항원(CEA)화S-100단백.진단:유두상한관낭선암.
A case of syringocystadenocarcinoma papilliferum was reported.A 76-year-old male patient presented with a neoplasm on the hypogastric region for more than 30 years.Recently the lesion became red,swelling and ulcerated for one month.Physical examination showed there was a 2 cru×2 cm sized dome-shaped brisht red firm tumor on the hypogastriura.The lesional surface showed a moist feature and was covered by hemorrhagic and mucoid exudations.The surrounding skin of the lesion was red and edematous.Histopathologic examination revealed that the tumor showed deep invaginations containing numerous papillary projections.These invaginations and papillary projections were lined by two-layered epithelium.The luminal layer was composed of columnar cells with oval nuclei and abundant eosinophilic cytoplasm,whereas the outer layer small eaboidal cells with oval nuclei and scanty cytoplasm.A large number of interstitial plasma cell infiltrations could be found.Irregular arrangement of the epithelial cells was present in the lower parts of these invaginations.In the deeper portion of the tumor,numerous irregular neoplastic tubular and cystic structures diffusely infiltrated the entire dermis in an invasive growth pattern.These neoplastic tubular and cystic structures were lined by monolayered or multilayered atypical ceils with enlarged,hyperehromatie nuclei.Cytologic atypia and mitotic figures were present.The tumor was positive for pan-CK, EMA and part GCDFP-15,but negative for CEA and S-100.The case was finally diagnosed as syringocystadenocarcinoma papilliferum.