皮脂腺痣伴发大汗腺囊腺瘤及先天性色痣一例

皮脂腺痣是一种较常见的皮肤肿瘤，可与其他皮肤附属器肿瘤并存，其中基底细胞上皮瘤及乳头状汗管囊腺瘤最为多见，伴有痣细胞痣的病例则十分罕见，现遇一例，报告如下。患者男，１７岁。出生时发现左颞部有斑片，数月后斑片上出现一小黑痣，无明显不适，随年龄增长斑片逐...     

皮脂腺痣合并大汗腺囊腺瘤1例

皮脂腺痣常与其他皮肤附属器肿瘤并存，可同时合并大汗腺囊腺瘤，报告1例皮脂腺痣合并大汗腺囊腺瘤。     

CO_2激光治疗皮脂腺痣58例

ＣＯ＿２激光治疗皮脂腺痣５８例邢勇君（东风汽车公司中心医院，湖北十堰市，４４２００８）皮脂腺痣（ｎｅｖｕｓｓｅｂａｃｅｕｓ）是一种皮肤良性肿瘤。近年来我们采用ＣＯ＿２激光治疗，取得了满意疗效。现将结果报告如下：１．临床资料：本组５８例皮脂腺痣系门诊患...     

皮脂腺痣、毛母细胞瘤、透明细胞汗腺瘤及乳头状汗腺腺瘤同时并发1例

正皮脂腺痣(nevus sebaceous)是一种表皮、真皮及表皮附属器所构成的器官样痣,其主要成分为皮脂腺。皮脂腺痣常并发皮肤良、恶性肿瘤。现在将我科诊治的1例皮脂腺痣并3种皮肤错构瘤患者的临床和组织病理分析如下。     

皮脂腺痣并发多发性基底细胞癌1例

报道1例皮脂腺痣患者并发10余个肿瘤,经病理组织学检查,诊断为皮脂腺痣及基底细胞癌.皮脂腺痣并发多发性基底细胞癌国内外尚未见报道.     

面部恶性雀斑样黑素瘤二例

例1女,37岁.右侧口角黑色斑片4年,多次手术切除仍复发就诊.患者于4年前无明显诱因右侧口角出现米粒大小黑色斑片,渐增大,当地医院行激光治疗,治疗后不久原皮损处又出现黑色斑片.此后1年中,黑色斑片进行性增大,无任何不适.3年前分3次手术切除该黑色斑,病理诊断为复合痣,皮脂腺痣.术后不久患处义出现褐色皮疹,渐增大至1 cm×1 cm大小.2年前再次切除,术后病理报告“交界痣”.     

皮脂腺痣伴多发基底细胞癌1例

皮脂腺痣是一种表皮、真皮及皮肤附属器所构成的器官样痣,临床上常见,通常出生即有,好发于头面部。皮脂腺痣可以伴发多种皮肤肿瘤,基底细胞癌是皮脂腺痣最常伴发的皮肤恶性肿瘤之一,但伴多发基底细胞癌患者并不常见,本文现报告1例。     

皮脂腺痣并发乳头状汗管囊腺瘤及基底细胞癌

报告1例皮脂腺痣患者,曾接受数次肿块平皮面削除手术后复发,全部皮损经组织病理学检查,病理诊断为皮脂腺痣并发乳头状汗管囊腺瘤及基底细胞癌.故皮脂腺痣皮损应彻底切除,并送组织病理检查,而不宜简单进行削平.     

皮脂腺痣继发肿瘤21例临床病理分析

目的 探讨皮脂腺痣继发肿瘤的临床表现与组织病理特征.方法 回顾分析21例皮脂腺痣继发肿瘤患者的临床和病理资料.结果 21例患者中,男12例,女9例,皮脂腺痣发生继发肿瘤的平均年龄为30.75岁.皮损位于头顶16例,位于面部5例.组织病理结果显示,皮脂腺痣继发肿瘤中,良性肿瘤为19例,常见肿瘤类型依次为毛母细胞瘤、乳头状...     

皮脂腺痣17例临床病理分析

目的　探讨皮脂腺痣与表皮及皮肤附属器错构瘤样结构的关系。方法　收集 17例皮脂腺痣 ,分析、总结其临床病史 ,病理学改变特点。结果　 14例 (82 %)初生时发病 ,男女之比为 1.3 0∶1(9∶8) ,本病主要表现为毛囊发育不良和皮脂腺增生 ,4例伴有表皮痣 ,1例伴有基底细胞癌 ,1例伴表皮样囊肿 ,6例伴有大汗腺异位。结论　皮脂腺痣是一种错构瘤样增生 ,常伴有其他表皮或皮肤附属器错构瘤样结构存在。     

PNA-binding sites in sebaceous tumors

The presence and distribution of peanut agglutinin (PNA)-binding sites was studied in normal sebaceous glands, nevus sebaceous, senile sebaceous hyperplasia, sebaceous adenoma, sebaceous epithelioma, and sebaceous carcinoma. Cell surface staining and sponge-like cytoplasmic staining was observed in sebaceous glands, nevus sebaceus and sebaceous hyperplasia. In sebaceous adenoma, sebaceous epithelioma, and sebaceous carcinoma, diffuse cytoplasmic staining was observed in addition to cell surface staining.     

Immunohistochemical staining for androgen receptors: a sensitive marker of sebaceous differentiation.

Androgen receptors (AR) are present in normal skin being localized to the basal and differentiating cells of the sebaceous gland, and as such, sebaceous glands are androgen sensitive tissue. Androgen receptor expression was examined in 43 sebaceous neoplasms including 8 sebaceous carcinomas, 22 sebaceous adenomas, 12 specimens showing sebaceous hyperplasia, and 1 sebaceous epithelioma, as well as in 14 squamous cell carcinomas, 2 clear cell acanthomas, and 35 basal cell carcinomas. Epithelial membrane antigen (EMA) expression was also examined in all of the sebaceous neoplasms. All specimens were fixed in formalin and embedded in paraffin. Diffuse positive nuclear androgen receptor antibody immunohistochemical staining was observed in all samples of sebaceous neoplasms, whereas approximately 60% of basal cell carcinomas showed only focal positivity for nuclear androgen receptor immunoreactivity. Clear cell acanthomas and squamous cell carcinomas were uniformly negative. Whereas all sebaceous neoplasms exhibited immunoreactivity for androgen receptors, the staining pattern was more marked in the nuclei of seboblasts and differentiating sebocytes in the adenomatous, hyperplastic, and epitheliomatous lesions than in the nuclei of the less differentiated sebaceous carcinoma cells. All the sebaceous neoplasms except for sebaceous carcinomas exhibited immunoreactivity for EMA. In the sebaceous carcinomas, EMA staining was absent in the most poorly differentiated specimen, but with increasing differentiation, the carcinomas became immunoreactive to EMA. We have shown that the nuclei of sebaceous neoplasms, including sebaceous gland carcinomas, show immunoreactivity for androgen receptors (AR), that immunohistochemical staining for the presence of AR may be a reliable marker of sebaceous differentiation, and that the AR may be a better marker of sebaceous differentiation than EMA, particularly in poorly differentiated sebaceous carcinomas.     

Immunolabeling pattern of cytokeratin 19 expression may distinguish sebaceous tumors from basal cell carcinomas

Background:  Distinction between sebaceous tumors and basal cell carcinomas can often pose diagnostic problems. Recent work with the antibody to cytokeratin 19 (CK 19) has shown that this marker has high specificity for undifferentiated basaloid cells. Our aim was to evaluate the use of CK 19 staining patterns in differentiating between sebaceous tumors and basal cell carcinomas. The sebaceous tumors that were examined in this study included sebaceous adenomas, sebaceous epitheliomas (sebaceomas) and sebaceous carcinomas.
Methods:  Thirty-seven cases including 5 sebaceous adenomas, 16 sebaceous epitheliomas, 6 sebaceous carcinomas and 14 basal cell carcinomas (7 being of the morpheaform type and 7 nodular basal cell carcinomas) were tested with a monoclonal mouse antibody to human CK 19.
Results:  CK 19 was focally positive in 1/5 (20%) sebaceous adenomas, 8/16 (50%) of sebaceous epitheliomas and 1/6 (17%) of sebaceous carcinomas. Strongly positive expression of CK 19 was not seen in any of the sebaceous adenoma, sebaceous epithelioma or sebaceous carcinoma specimens. CK 19 was found to be strongly positive in 9/14 (64%) and focally positive in 2/14 (14%) of basal cell carcinomas.
Conclusion:  CK 19 expression can be helpful in differentiating sebaceous tumors (including sebaceous adenomas, sebaceous epitheliomas and sebaceous carcinomas) from basal cell carcinomas and may be a useful adjunct when these entities are included in the differential diagnosis.     

皮脂腺肿瘤凝集素亲合组化研究

本研究采用１７种生物素化的凝集素，应用ＡＢＣ法研究了２３例正常皮肤和２２例皮脂腺良、恶性肿瘤的肿瘤细胞凝集素受体的定位及分布，发现ＬＣＡ在皮脂腺癌的阳性率较高；正常皮脂腺、皮脂腺痣、皮脂腺增生、皮脂腺腺瘤可见胞膜及胞浆的海绵、网状着染；皮脂腺癌中胞浆失去这种规则着染，着染形状及分布极不规则，说明在皮脂腺恶性转化过程中，细胞表面复合糖糖基及细胞的正常结构发生了明显的变化。     

Cytokeratin 15 expression in neoplasms with sebaceous differentiation

BACKGROUND: Recent studies have demonstrated that the cytokeratin 15 (CK15)-positive stem cells located in the hair follicle bulge are also involved in sebaceous gland renewal. No previous studies have dealt with the CK15 expression in sebaceous neoplasms. METHODS: We studied the CK15 expression in 30 sebaceous neoplasms including 10 sebaceomas (sebaceoma defined as a distinct benign neoplasm with sebaceous differentiation), 10 sebaceous neoplasms of Muir-Torre syndrome, and 10 sebaceous carcinomas, in addition to that in the mantles of normal hair follicles. RESULTS: CK15 was positive in the undifferentiated sebocytes of the mantles. All 10 sebaceomas showed CK15 expression in the basaloid, germinative cells. Both sebaceous neoplasms in Muir-Torre syndrome and sebaceous carcinomas demonstrated negative or only a focal positive reaction, including the occasional aberrant expression in matured sebocytes, to CK15. CONCLUSIONS: CK15 may be a useful marker for stem cells with a sebaceous fate, and a constant CK15 expression in sebaceomas supported the hypothesis that sebaceoma is a benign neoplasm of sebaceous germinative cells in the mantles. The similar staining pattern of CK15 between sebaceous neoplasms in Muir-Torre syndrome and sebaceous carcinomas may be one piece of evidence supporting the hypothesis that most sebaceous neoplasms in Muir-Torre syndrome are low-grade sebaceous carcinomas.     

Sebaceous neoplasms in Muir-Torre syndrome

A 59-year-old Japanese woman presented with two sebaceous neoplasms on the chest wall and on the left cheek. The patient had a history of ascending colon cancer, and her mother had died of gastric cancer. The histopathologic features of both sebaceous neoplasms were vaguely in accordance with those of sebaceous adenoma and sebaceoma. Based on these findings, we diagnosed the patient as having Muir-Torre syndrome. The sebaceous neoplasm on the chest wall exhibited features of a sebaceous adenoma with a unique cystic appearance, namely cystic sebaceous adenoma, which has been reported as a specific marker for Muir-Torre syndrome (MTS). However, histopathologically, both the sebaceous adenoma and sebaceoma had relatively large, vesicular or heterochromous and crowded nuclei with some pleomorphism and distinct nucleoli associated with some mitotic figures, casting doubt on their benignancy. We show that some or most benign sebaceous neoplasms in MTS might have a high potential for malignant transformation or may be well-differentiated sebaceous carcinomas with low-grade malignancy, mimicking sebaceous adenoma/sebaceoma. This results in difficulties in classification regarding sebaceous neoplasms in MTS.     

Expression of α‐methylacyl‐CoA racemase (P504S) in sebaceous neoplasms

Background: α‐Methylacyl‐CoA racemase (AMACR), also known as P504S, is a protein that plays an important role in mitochondrial and peroxisomal β‐oxidation of branched‐chain fatty acid and bile acid intermediates. AMACR has been established as a valuable diagnostic marker for prostate cancer and has recently been shown to be useful in the diagnosis of colorectal carcinoma. Despite the importance of lipid metabolism in sebum production by sebaceous glands of the skin, there are no studies evaluating the expression of AMACR in sebaceous neoplasms. Methods: Five samples of normal sebaceous glands as well as five cases each of sebaceous hyperplasia (SH), sebaceous adenoma (SA), basal cell carcinoma (BCC) with sebaceous differentiation and extraocular sebaceous carcinoma (SC) were evaluated for immunohistochemical (IHC) expression of AMACR. Each case was reviewed by a single dermatopathologist and graded using a semi‐objective grading schema. Results: Normal sebaceous glands showed strong (4+) expression of AMACR. Among sebaceous neoplasms, SH showed the highest expression (4+), SA and BCC with sebaceous differentiation showed varied expression (2+ and 1+, respectively), and extraocular SC showed no expression of AMACR. Conclusions: The expression of AMACR is increased in benign sebaceous glands and SH; with decreasing AMACR expression in tumors with less sebaceous differentiation (i.e. SA and SC). These findings provide insight into the potential pathogenesis of sebaceous neoplasms while assisting in the microscopic distinction of SA from SC. Halsey MA, Calder KB, Mathew R, Schlauder S, Morgan MB. Expression of α‐methylacyl‐CoA racemase (P504S) in sebaceous neoplasms.     

无水酒精灌注皮脂腺囊腔法治疗面部皮脂腺囊肿16例

目的比较无水酒精灌注皮脂腺囊腔法与皮脂腺囊壁摘除法治疗颜面部皮脂腺囊肿的疗效。方法将32例皮脂腺囊肿患者随机分为治疗组与对照组,每组16例。治疗组采用无水酒精皮脂腺囊腔灌注,对照组采用皮脂腺囊腔摘除。结果治疗组16例患者及对照组16例患者均痊愈,两组痊愈率相同。结论无水酒精灌注囊腔法治疗颜面部皮脂腺囊肿不用取出皮脂腺囊壁,手术简单,值得应用。     

Neonatal sebaceous glands: fine structure of sebaceous and dendritic cells.

Ultrastructural features of sebaceous glands in newborns were examined in adnexal polyp lesions of neonatal skin. Material for electron microscopy was obtained from the nipple areola of 10 Japanese newborn babies of both sexes, less than 8 days of age. The cell organization of the neonatal sebaceous acini consisted of undifferentiated, differentiating, and mature sebaceous cells, and the sequence of sebaceous transformation seemed to be consistent with that described in the postnatal acini. The sheet of continuous basal lamina covering the sebaceous acini was neither distorted nor convoluted. This configuration in the basal lamina revealed no convincing evidence for physiological involution of the neonatal sebaceous cells were identified at the outer periphery of the sebaceous glnads. Melanocytes in symbiosis with the sebaceous acini in concurrent presence of Langerhans cells.     

Sebaceoma and related neoplasms with sebaceous differentiation: a clinicopathologic study of 30 cases

The classification of benign sebaceous neoplasms has been challenged both by the assertion that sebaceous adenomas are really carcinomas and by difficulties in drawing the boundaries between sebaceomas and other lesions. We performed a clinicopathologic study of 30 cases of basaloid neoplasms with sebaceous differentiation, excluding cases of definite sebaceous carcinoma with severe nuclear atypia invading deep within the subcutaneous tissue and those of ocular sebaceous carcinoma. We tried to classify sebaceous neoplasms in six categories with defined histopathologic criteria. All the neoplasms were characterized by aggregations of basaloid cells admixed with sebocytes and sebaceous duct-like structures located in the dermis with or without connection to the epidermis. The categories were 1) sebaceoma (14 cases); 2) trichoblastoma with sebaceous differentiation (3 cases); 3) apocrine poroma with sebaceous differentiation (2 cases); 4) low-grade sebaceous carcinoma (6 cases); 5) sebaceous carcinoma (4 cases); and 6) basal cell carcinoma with sebaceous differentiation (1 case). The sebaceoma was further subclassified as classic type (12 cases) or verruca/seborrheic keratosis type (2 cases). Although most sebaceomas can be distinguished from other lesions, there are problematic cases. We discuss the histopathologic diagnostic problems associated with sebaceoma and also argue in favor of the concept of sebaceous adenoma.