皮脂腺瘤31例临床病理分析

目的：对皮脂腺瘤进行临床病理分析。方法回顾性分析31例皮脂腺瘤患者的临床病理资料，结合免疫组化，总结其临床病理学特征。结果31例皮脂腺瘤中男9例，女22例，年龄（53.90±15.40）岁，病程（9.41±13.75）年，皮损位于面部者最常见，形态为丘疹，颜色分别呈红色、黄红色、正常肤色、淡褐色，大多无明显自觉症状。组织病理检查显示，肿瘤位于真皮内，所有肿瘤组织结构对称，其中9例与表皮相连。肿瘤细胞为基底样细胞及少许成熟皮脂腺细胞和部分过渡细胞，26例肿瘤组织中偶见成熟皮脂腺细胞（<1%），2例成熟皮脂腺细胞<20%，3例成熟皮脂腺细胞占20%~40%。5例部分区域偶见核分裂像。1例合并小汗腺汗孔瘤。31例均可见数量不等的导管。免疫组化结果显示，上皮膜抗原在皮脂腺瘤导管及成熟皮脂腺细胞全部呈阳性表达，上皮抗原在所有皮脂腺瘤中均不表达，20例皮脂腺瘤的导管癌胚抗原阳性，24例雄激素受体阳性，28例D2?40阳性。结论皮脂腺瘤的诊断主要依靠组织病理检查。免疫组化检查抗上皮膜抗原抗体、抗雄激素受体抗体和D2?40的组合有利于与其他肿瘤鉴别。

Sebaceoma：a clinicopathological analysis of 31 cases

Objective To analyze clinicopathologic features of sebaceoma. Methods Clinical, pathologic and immunohistochemical findings from 31 cases of sebaceoma were retrospectively analyzed. The clinicopathologic features of sebaceoma were investigated. Results There were 9 males and 22 females. The patients′ age was 53.90 ± 15.40 years, and the clinical course was 9.41 ± 13.75 years. Sebaceoma predominantly affected the face. The common lesion of sebaceoma was red, yellowish?red, skin?colored or slight brown papules, with no subjective symptoms in most cases. Histopathologically, neoplasms had symmetric structures, and were located in the dermis. Epidermal involvements were found in 9 cases. The neoplasm cells were mainly composed of basaloid cells, a few mature sebocytes and some transition cells. The proportion of mature sebocyts was less than 1%in 26 cases, less than 20%in 2 cases, and 20%-40%in 3 cases. Mitoses were occasionally found in 5 cases. One patient was complicated by eccrine poroma. Varying amounts of ducts were found in all the patients. Immunohistochemical staining showed that epithelial membrane antigen was expressed on ducts and mature sebocytes in all the patients, while epithelial antigen was undetected in any of the patients. Carcinoembryonic antigen, androgen receptor and D2?40 were found in 20, 24 and 28 patients with sebaceoma, respectively. Conclusions The diagnosis of sebaceoma mainly depends on histopathological examination. Combined immunohistochemical detection of epithelial membrane antigen, androgen receptor and D2?40 is beneficial to its differential diagnosis.