皮肤混合瘤12例

对我院2008年至2020年6月12例皮肤混合瘤患者资料进行回顾性分析。12例患者中男7例,女5例,发病年龄为22~77岁。12例均发生于面部 (上唇部最多见),其中11例表现为单发无自觉症状的淡红色或肤色坚韧肿物,1例因外界因素出现破溃。组织病理示9例向大汗腺分化,3例向小汗腺分化。12例患者中,临床诊断为皮肤混合瘤仅1例,诊断为皮肤纤维瘤和表皮样囊肿的各3例,诊断为钙化上皮瘤、附属器肿瘤和皮角各1例,皮疹待查2例。12例患者均行手术切除,随访2个月~6年,均无复发。     

皮肤混合瘤2例

目的:加强对皮肤混合瘤(MTS)的认识,提高临床诊断准确率。方法:报告2例男性皮肤混合瘤患者的临床及组织病理学特点,回顾近年来有关皮肤混合瘤的文献资料。结果:2例患者均经组织病理及免疫组化检查确诊为皮肤混合瘤,最终行Mohs手术治疗。结论:皮肤混合瘤较少见,临床表现无特征性且易被误诊,确诊需结合组织病理学检查。该病一般呈良性表现,最佳治疗方法是行Mohs手术完整切除,可有效防止复发。     

皮肤混合瘤17例临床及组织病理分析

目的探讨皮肤混合瘤临床、组织病理特点及鉴别诊断。方法回顾性归纳分析华中科技大学同济医学院附属协和医院皮肤科1999—2017年17例皮肤混合瘤患者的临床病理资料。结果 17例患者中14例向顶泌汗腺分化,其中10例有明显的管泡状结构,9例有导管结构,4例见角质囊肿及毛乳头结构;17例患者均见黏液样、纤维化间质,间质中均见浆细胞样细胞、多角形细胞、梭形细胞,1例出现软骨样间质;初诊误诊15例,误诊率为88.24%。结论皮肤混合瘤虽然组织病理学上具有特征性,但临床误诊率极高,应引起临床医生的重视。     

皮肤混合瘤患者的临床及组织病理分析

目的 分析皮肤混合瘤患者的临床及组织病理特点.方法 收集2015年1月至2020年1月在某医院治疗的10例皮肤混合瘤患者的临床资料进行回顾分析,观察其临床病理特征,鉴别诊断,治疗效果等情况.结果 初诊误诊8例,误诊率为80%,所有患者均行手术切除,术后随访(3～5)年,均无复发.10例皮肤混合瘤均位于真皮中下部,9例境...     

16例单发性毛发上皮瘤临床与病理观察

目的：探讨单发性毛发上皮瘤的临床表现、病理特征、诊断要点及预后。方法：所有病例行局部皮肤肿瘤切除,常规组织切片、染色,随访观察2年。结果：16例病理诊断为单发性毛发瘤病例中,其中有14例临床误诊。15例术后无复发,1例继发鳞癌。组织病理有典型的形态特征,镜下与基底细胞癌相似,可表现有基底样细胞组成的小叶结构或团块结构,瘤巢周边细胞呈栅状排列,但有向毛发分化的倾向和角质囊肿形成等。结论：单发性毛发上皮瘤临床极易误诊,组织病理学特征是本病确诊的主要依据。     

毛发上皮瘤的皮肤影像学特征分析

【摘要】 目的 比较毛发上皮瘤的反射式共聚焦显微镜（RCM）和皮肤镜特征与组织病理学特征。方法 2017年1月至2018年12月于武汉市第一医院皮肤科门诊收集经组织病理学确诊的毛发上皮瘤患者23例,采集RCM、皮肤镜图像,对比其与组织病理学特征的一致性。结果 23例中,男5例,女18例,年龄（39.5 ± 22.1）岁。组织病理特征：肿瘤界限清楚,周围有丰富的纤维基质;肿瘤团块为多数基底样细胞集合或相互交织的基底样细胞索,周边细胞呈栅栏样排列;肿瘤细胞不同程度地向毛乳头分化;可见不等数量的角囊肿。RCM特征：23例患者中8例可见真表皮交界处芽蕾样下延的条索状细胞,有栅栏样排列趋势;18例可见真皮层散在分布结节状似有分叶的瘤团,与周围组织无收缩间隙,呈扩大的低回声结构;16例瘤团周围有中高折光的无定形基质包绕;16例患者可见特征性的疑似原始分化毛乳头结构;20例可见清晰的角囊肿。皮肤镜特征：20例可清晰观察到珍珠白色、均质状结构,10例线状毛细血管扩张。结论 毛发上皮瘤的RCM特征与组织病理具有较高一致性,可作为辅助诊断及鉴别诊断的有效方法。     

麻风性滑膜炎

为确定麻风患者的原发性滑膜受侵是否是关节炎的病因,作者对50例患有关节炎的瘤型麻风患者(皮肤病理检查确诊)进行了滑膜的组织病理学研究.患者均接受过一定时期(1～5年)的治疗,年龄大多在30岁左右,其中14例并发麻风反应.50例中,6例双侧膝关节受侵,44例除膝关节外,踝关节受侵18例、腕及肘关节各9例.另外以10例无关节症状的瘤型麻风患者作为对照.滑膜取自无麻风皮损的膝关节.每个患者均作了受侵关节的X线检查、梅毒血清试验、风湿因子测定、血象及尿检查.结果,对照组10例的滑膜组织无异常.而患有关节炎的50例瘤型病人均有慢性滑膜炎的改变.其中无麻风反应的36例的滑膜内层显示增生,滑膜绒     

皮肤型Rosai-Dorfman病14例临床病理分析

目的探讨皮肤型Rosai-Dorfman病的临床组织病理特点,提高临床医生对该病诊断及治疗的认识。方法回顾性分析新疆医科大学第一附属医院皮肤科2012年—2017年收治的皮肤型Rosai-Dorfman病14例,分析其临床资料、组织病理学特点,并复习相关文献,总结其诊断及治疗。结果经筛选后共纳入14例经组织病理及免疫组化确诊的皮肤型Rosai-Dorfman病患者,其中男5例,女9例;汉族12例,维吾尔族1例,回族1例。年龄18~72岁,平均年龄(48±14)岁。临床诊断与组织病理诊断均符合皮肤型Rosai-Dorfman病者4例,14例患者免疫组化染色结果均表现为S-100蛋白及CD68阳性,CD1a阴性。结论皮肤型Rosai-Dorfman病有一定的临床和组织病理学特点,对于单发或面积较小的皮损,手术切除效果较好,皮肤科医生应该提高对该病的认识,以减少误诊和误治。     

牛黄晶治疗毛发上皮瘤30例临床观察

<正>1临床资料1.1病例选择病例均经组织病理学确诊,符合毛发上皮瘤的诊断标准[1]。血常规、尿常规、血小板、出凝血时间及心电图检查均正常。排除妊娠、哺乳期患者。1.2一般资料病例均为2008年1月—2010年1月我院中医外科门诊患者,共60例。男性12例,女性48例;病程1～32年;年龄8～48岁。60例患者随机分为治疗组和对照组,各30例,2组一般资料差异均无统计学意义(P0.05),具有可比性。     

鼻尖部皮肤混合瘤2例

例1女,40岁,鼻尖部无痛性肿物2年;例2女,36岁,鼻尖下方无痛性肿物3年。2例均表现为鼻尖部皮下结节,淡红色,表面光滑,边界清楚,中等硬度,无压痛。皮肤组织病理检查均支持"皮肤混合瘤"的诊断。     

Mixed tumor of the skin

An 81-year-old woman presented with a skin-colored, slowly growing tumor on her right lower eyelid. The diagnosis of mixed tumor of the skin was confirmed after excision and histologic examination of the tissue, which demonstrated a characteristic histology and immunohistochemistry. The mixed tumor of the skin is a usually benign neoplasm believed to originate in sweat glands. It is composed of epithelial cells set in a mesenchymal matrix, showing apocrine differentiation. Immunohistochemical staining is positive for cytokeratin, CEA, EMA and S100.     

男性阴茎附属腺和皮肤淋球菌感染皮损的高频超声研究

【摘要】 目的 了解男性阴茎皮肤和附属腺淋球菌感染皮损的超声影像学表现及其临床意义。方法 2014年1月至2021年1月在常熟市第一人民医院皮肤科纳入经实验室检查确诊且既往未接受过相关治疗的男性阴茎皮肤和附属腺淋球菌感染患者。使用SIEMENS ACUSON X300实时超声显像仪检测阴茎体表淋球菌感染皮损,探头频率7.5 ~ 15 MHz。高频超声影像表现为管状液性暗区者仅予头孢曲松1 g单剂肌内注射;椭圆形液性暗区者,切开引流同时予头孢曲松1 g肌内注射,每天1次,共5 d;低回声区、混合回声区者予头孢曲松1 g肌内注射,每天1次,共5 d,治疗后1个月结节仍不消退者,局部切除结节。治疗后1个月复诊并观察疗效。结果 共收集32例男性阴茎皮肤和附属腺淋球菌感染患者,年龄（28.54 ± 3.27）岁,均有非婚性接触史,非婚性接触至症状出现时间为（4.45 ± 1.03） d,病程（8.64 ± 1.87） d。皮损均单发,位于尿道外口16例（50.00%）,龟头7例（21.88%）,包皮系带旁5例（15.62%）,阴茎缝4例（12.50%）。皮损表现：窦道样损害16例（50.00%）,脓肿9例（28.13%）,结节7例（21.87%）,皮损处均有触痛。高频超声检查：16例（50.00%）表现为管状液性暗区,7例（21.88%）为椭圆形液性暗区,5例（15.62%）为低回声区,4例（12.50%）为混合回声区。16例（50.00%）淋球菌感染累及尿道海绵体,5例（15.62%）累及阴茎海绵体,11例（34.38%）累及阴茎皮下。经治疗,32例均痊愈。结论 高频超声可用于男性阴茎皮肤和附属腺淋球菌感染患者的皮损评估和治疗方案的选择。     

Adenocarcinoma of mammary-like glands of the vulva: Report of a case and review of the literature

Mammary-like glands are a poorly recognized structure of normal vulvar skin. Adenocarcinomas arising from these glands are rare and represent a distinct clinicopathologic entity that must be distinguished from metastatic tumors. We reviewed 19 cases reported in the literature and describe a 51-year-old patient with a long-standing nodule on her right interlabial sulcus. Excisional biopsy and Mohs micrographic surgery demonstrated an infiltrating adenocarcinoma of the mammary-like glands involving the dermis and subcutis. On review of all 20 cases, the mean age at diagnosis was 59.6 years, the labia majora were involved in 13 cases (65%), and the mean lesional size was 2.5 cm. The tumor's histologic patterns varied greatly, although the histomorphologic similarity among this neoplasm, sweat gland carcinomas, and invasive extramammary Paget disease suggested a morphologic spectrum among these tumors. Criteria for establishing the diagnosis of adenocarcinoma of mammary-like glands include identifying transition zones between normal mammary-like glands and adenocarcinomatous areas. This tumor is best categorized as a locally aggressive neoplasm with a low risk for widespread metastasis. Use of aggressive surgical therapeutic regimens, particularly in the case of tumors localized to the skin, must be reassessed, especially given the likelihood of long-term morbidity with such regimens. In our patient, successful Mohs micrographic surgery suggests that alternate management may be adopted for tumors localized to the skin, especially in elderly patients.     

Zosteriform metastatic skin cancer: report of three cases and review of the literature.

BACKGROUND: Metastatic skin cancer is a rare complication of internal malignancies. Patients who do develop skin metastases seldom present with a zosteriform distribution. OBJECTIVE: To elucidate the characteristics of zosteriform metastatic skin cancer, 15 cases from the medical literature and 3 cases seen in our clinic were reviewed clinically and histopathologically. METHODS: The age and sex of each patient, site of the primary tumor, pathology of primary and metastatic lesions, location of the skin cancer and presence of pain were determined for the 18 cases of zosteriform skin cancer. RESULTS: The most frequent site of the primary tumor was the breast (4 cases), ovary or lung (3 cases each), prostate, bladder or stomach (2 cases each) and uterus or colon (1 case each). The most common site of the skin metastases was the chest wall (8 cases) and abdominal wall (7 cases). The histology of the primary lesion was compatible with adenocarcinoma (10 cases), transitional cell carcinoma or serous papillary cystadenocarcinoma (2 cases each) and ductal carcinoma (1 case). Eleven cases developed on the nearest covering skin and/or on the same side as the primary tumor. Eleven patients complained of pain. Seven cases were treated as herpes zoster with antiviral agents. CONCLUSION: Approximately 50% of cases of metastatic skin cancer developed on the nearest skin covering and on the same side as the primary tumor. This evidence may be useful when trying to pinpoint the location of the primary tumor. One third of patients with skin metastases were misdiagnosed and their lesions were treated initially as herpes zoster. When a band-like eruption is seen in patients with internal malignancies, the possibility of metastatic skin lesions should be considered. A skin biopsy is necessary to confirm the diagnosis.     

Ectopic breast tissue and breast-like sweat gland metaplasias: an overlapping spectrum of lesions

There are many similarities in the morphology of benign and malignant lesions of the sweat glands and the breasts. The recently described cutaneous mammary-like sweat glands, also known as mixed sweat glands or apoeccrine glands, are also a likely source of selected proliferations that closely mimic those of the breast. We present three cases of breast-like lesions arising in the skin that demonstrate the ways in which the morphologic and pathologic continuum of the mammary glands, cutaneous mammary-like glands, and sweat glands can produce difficulties in precise diagnosis. The examples demonstrate that an anatomic location outside the milk line does not preclude the diagnosis of ectopic mammary tissue, and that lesions closely resembling those of the breast may also arise outside the milk line from conventional sweat glands or mixed sweat glands. The concept of homologous lesions of the breast, breast-like glands and sweat glands, in which morphology is partially mirrored by biochemical similarities, provides a perspective for classification of problematic cases of breast-like cutaneous lesions.     

Cutaneous apocrine mixed tumor with intravascular tumor deposits: a diagnostic pitfall

Apocrine mixed tumor of the skin is a benign adnexal neoplasm usually posing no diagnostic problem for a histopathologist. The purpose of our investigation is to present a small series of 4 benign cutaneous apocrine mixed tumors of the skin that contained small foci of intravascular tumor deposits, a feature not previously described, to the best of our knowledge. The 4 lesions were identified retrospectively after a review of 312 apocrine mixed tumors and 51 eccrine mixed tumors in the collective files of the authors. In all cases, this feature was originally overlooked. The patients were 3 men and 1 woman, ranging in age at diagnosis from 29 to 66 years. Locations included nose (2), forehead (1), and the fifth toe (1). Histopathologically, all 4 neoplasms demonstrated typical features of a benign apocrine mixed tumor; 2 cases were classified as hyaline cell-rich tumors. In all cases, there were either blood or lymphatic vessels containing small intraluminal collections of neoplastic cells, which had the appearances of hyaline cells and immunohistochemically expressed cytokeratins and were partly immunoreactive for S-100 protein and calponin, thus indicating the myoepithelial phenotype. The intravascular location of the neoplastic cells was confirmed by CD31 staining. The nature of the vessels (lymphatics vs. blood vessels) was supported by staining for alpha smooth muscle actin, which stained pericytes in blood vessels. Lymphatic vessels were also stained for D2-40. No eccrine mixed tumor manifested intravascular tumor deposits. Follow-up of the patients revealed no recurrences or metastasis (range: 2-21 years). It is concluded that occurrence of intravascular involvement in benign apocrine mixed tumor of the skin is rare (approximately 1%-2%). This feature is discrete and is easy to overlook. At present, its significance is not completely clear. Until proved otherwise in future, we suggest to consider intravascular deposits in cutaneous apocrine mixed tumors as an innocuous phenomenon.     

Apocrine adenomyoepithelioma--a rare but distinctive primary sweat gland neoplasm

Adenomyoepithelioma is a rare, microscopically distinctive tumor of the skin. This article explores an example that presented in the inguinal area in a 29-year-old woman, mimicking adenopathy. Histopathologically, the tumor included two different areas: a cystic area consisting of tubules and glands in hyalinized stroma and a solid area showing marked myoepithelial proliferation. The diagnosis of adenomyoepithelioma was confirmed by the presence of a biphasic immunoprofile, with expression of cytokeratins and epithelial membrane antigen in the glandular epithelium and with expression of vimentin and smooth muscle actin in the myoepithelial cells. An interesting novel finding was the expression of claudin-10 by myoepithelial cells, which to date has not been reported in the literature. The absence of metaplastic changes in the tumor stroma is crucial in the differential diagnosis with apocrine mixed tumor. Given that soft tissue adenomyoepithelioma is a benign tumor believed to originate from conventional sweat glands, its classification as a cutaneous myoepithelial neoplasm seems reasonable.     

Local recurrence of cutaneous mixed tumor (chondroid syringoma) as malignant mixed tumor of the thumb 20 years after initial diagnosis

Benign cutaneous mixed tumor (chondroid syringoma) is the cutaneous counterpart of the benign mixed tumor (pleomorphic adenoma) of salivary glands, consisting of both epithelial and mesenchymal elements. The incidence of cutaneous mixed tumor is rare, composing <0.01% of all primary skin tumors. Herein, we report a case of malignant mixed tumor which recurred in the right thumb 20 years after the reported initial diagnosis of a benign mixed tumor at this site. Histologically, the lesion consisted of highly atypical and infiltrative cells in cords and ductal structures, with an adjacent focus of residual benign mixed tumor present. Perineural invasion of multiple dermal and subcutaneous nerves was also seen. Immunohistochemical staining was strongly and diffusely positive for CK5/6 and p63, with patchy positive S100 and CK7 staining. Wide excision was performed, with no evidence of recurrence or metastasis 5 years later.     

Chondroid syringoma: a clinical and histological review of eight cases

IntroductionChondroid syringoma is a rare skin tumor that presents as a slow growing, indolent lesion, that is more frequent in male adults and is usually benign. It is treated surgically and its diagnosis is histological. It can be classified as eccrine and apocrine according to its pathological characteristics.Material and methodsEight cases diagnosed of chondroid syringoma in our Department in the last eight years were reevaluated clinically and histologically and the epiluminiscence microscopy was used in one of them.ResultsMost of the cases occurred as well-defined nodular lesions, whose presumptive clinical diagnosis was adnexal or cystic pathology. All were treated surgically. The epiluminiscence microscopy showed a pattern of homogenous whitish-blue coloring. All the cases had a myxoid matrix and most also had a chondroid one. Five of the eight cases were apocrine, one of them with follicular and sebaceous differentiation.DiscussionThe chondroid syringoma is usually a small-sized skin tumor, frequently on the head and neck. The dermatoscopy does not seem to supply any specific trait to this lesion. The microscopic examination of these lesions reveals tubuloalveolar and glandular type structures positioned as islets within a fibroadipose, chondroid, myxoid or hyaline stroma. The final treatment of these tumors is surgical. As a general rule, it is a benign tumor. Some authors have proposed the term of atypical mixed tumor of the skin for those chondroid syringomas with histological traits of malignancy but without evidence of metastasis.