皮肤Merkel细胞癌伴鳞状细胞癌1例

患者女,76岁。左面颊部肿物1年,明显增大1个月。皮损特点为紫红色球形肿物。皮损组织病理示:表皮见团块状鳞状上皮中-重度异型增生,突破基底膜;真皮全层见形态一致的肿瘤细胞浸润,巢状或片状分布,圆形或卵圆形,胞质少、嗜碱性,核大、散点状分布染色质,核仁明显,可见多数核分裂相。免疫组化:CK20(部分+),P63及CKH(鳞状分化的细胞+),Syn(+),CgA(+),CD56(+),LCA(-),CK7(-),S100(-)。诊断:皮肤Merkel细胞癌伴鳞状细胞癌。

A Case of Merkel Cell Carcinoma with Squamous Cell Carcinoma

A 76-year-old woman has presented with tumor on her left cheek for 1 year, which increased significantly for 1 month. The tumor was reddish-blue and spherical. Histopathological examination of the tumor revealed squamous cells moderate-severe dysplasia in the part of epidermis with breaking the basement membrane, which was positive to P63 and CKH. The dermis of lesions showed monomorphic cells with basophilic, scanty cytoplasm and regular nuclei having finely dispersed chromatin and a high mitotic rate arranged in diffuse distribution or nests, which was positive to CK20, Syn, CgA and CD56 but negative to LCA, CK7 and S100. The diagnosis was merkel cell carcinoma with squamous cell carcinoma.