41例皮肤基底细胞癌的临床病理及误诊分析

目的：分析总结41例皮肤基底细胞癌的临床病理特点及误诊情况。方法：对41例皮肤基底细胞癌的临床及病理资料进行回顾性分析。结果：41例皮肤基底细胞癌中,发病年龄中位数为59岁（34～82岁）,多发于头面部,共39例,占95．1％,通过组织病理检查,41例均证实为基底细胞癌。其中9例进行免疫组化标记示CK（＋）,S-100（-）。临床诊断为基底细胞癌24例,占58．5％,误诊为脂溢性角化4例,黑素细胞痣3例,鳞状细胞癌、黑素细胞瘤、寻常狼疮各2例,误诊为其他4例。结论：被误诊的皮肤基底细胞癌患者大多数年龄较大,病程缓慢,临床表现不典型。尽早行组织病理检查,并结合免疫组化标记进行识别,可提高皮肤基底细胞癌的诊断准确率。     

皮肤基底细胞癌70例临床病理分析

目的探讨皮肤基底细胞癌(BCC)临床病理特点及诱发因素。方法对70例患者的临床及组织病理资料进行分析。结果按皮肤损害分型,结节溃疡型38例,色素型14例,浅表型6例,硬斑型10例,纤维上皮瘤型2例。97.2%的肿瘤发生于头面部暴露部位。结论紫外线是BCC的重要诱因。采用扩切病变部后植皮术或旋转皮瓣,既达到根治目的,又保持美观。     

62例基底细胞癌误诊的临床及组织病理分析

目的分析62例基底细胞癌误诊情况,提高诊断水平,避免误诊误治。方法回顾性分析62例基底细胞癌初步误诊病人临床及组织病理资料。结果 62例患者中误诊为脂溢性角化病7例;色素痣6例;鳞状细胞癌4例;恶性黑素瘤3例;Bowen病3例;日光性角化病2例;乳房外paget病3例;化脓性肉芽肿3例;血管瘤2例;寻常疣3例;炎性肉芽肿3例;表皮囊肿3例;毛母细胞瘤3例;皮肤溃疡4例;盘状红斑狼疮1例;增生性瘢痕2例;皮肤纤维瘤2例;蓝痣1例;包块性质待诊7例。结论提高临床水平及皮肤病检水平不仅减少误诊误治,更重要的是为治疗做出更好的选择。     

62例基底细胞癌临床和病理分析

基底细胞癌又称基底细胞瘤、基底细胞上皮瘤 ,是发生在皮肤任何部位的一种常见的皮肤肿瘤 ,其临床和病理可分多种类型。我们收集 1990～ 1999年临床、病理确诊且资料完整的基底细胞癌共 6 2例 ,分析如下。1　临床资料6 2例中男 2 2例 ,女 40例 ,男女之比1:1.82 ;年龄最小 2 8岁 ,最大 85岁 ,平均年龄 6 3.2 4岁 ;年龄分布 <30岁 1例、30～39岁 3例、40～ 49岁 6例、5 0～ 5 9岁 17例、6 0～ 6 9岁 2 5例、70～ 79岁 7例、>80岁 3例 ;病期最短 2个月 ,最长 14年 ,平均 5 .4年 ,其中 5年以上 32例 ( 5 1.6 1% )。肿瘤部位 :头、面、颈部共 5 5…     

砷引起基底细胞癌的临床和病理特点

在新疆奎屯车排子地区曾饮高砷井水,其砷含量０．６ｍｏｌ／Ｌ,使用期１５年,１９８４年底起改饮符合卫生标准的水。１９８２年～１９９２年我们从８５例确诊的地方性慢性砷中毒（ｅｎｄｅｍｉｃｃｈｒｏｎｉｃａｒｓｅｎｉｓｍ,ＥＣＡ）患者中,共取砷性皮损活检标本...     

基底细胞癌31例临床及病理分析

基底细胞癌又名基底细胞上皮瘤 ,是一种低度恶性的皮肤肿瘤 ,临床上常单发 ,男女并无差异。现将临床上所遇 31例并经病理证实的基底细胞癌总结分析如下 :1　临床资料1.1　性别与年龄分布 :共 31例 ,其中男性 19例 ,女性 12例 ;年龄 :从 2 9～ 79岁 ,其中 5 0岁以下者 5例 ,5 0岁及以上者 2 6例 ,计 31例 ,平均 5 8.7岁。1.2　病程分布　从 6个月到 30年 ,其中1年以内者 1例 ;1～ 5年者 17例 ;6～ 10年者 11例 ;10年以上者 2例 ;平均病程6 .3年。1.3　肿瘤部位分布　颜面 13例 ;头皮 8例 ;胸 2例 ;腰背 3例 ;上肢 3例 ;下肢 2例。1.4　肿瘤大…     

皮肤基底细胞癌55例临床与病理分析

目的 通过分析基底细胞癌(BCC)临床病理特点,提高BCC的诊断水平,增强群众健康防病意识.方法 对55例BCC患者的临床资料进行综合性分析.结果 BCC患者中男、女比例为1∶1.29,年龄23～90岁,其中 50～79 岁占 81.82 %,农牧民居多(39例).BCC病程长短不一,多发生于头面部.临床表现为多形性,容易误诊,误诊率达 23.64%,各临床类型中以色素型最易误诊.BCC临床上以结节溃疡型(33例)及色素型(11例)为多见.BCC病理分型中以实体型最多见(25例).结论 BCC的发生与慢性长期日光照射密切相关,病理检查对该病的正确诊断、治疗和预后判断起着重要作用.     

203例皮肤基底细胞癌临床与病理分析

目的研究分析基底细胞癌(Basal cell carcinoma,BCC)临床表现及组织病理特征,提高基底细胞癌的诊治水平。方法对203例基底细胞癌患者的临床表现、组织病理进行综合分析。结果所收集203例病例中,男女比例为1∶1.23,年龄50岁的病例占9.36%,其中60岁的病例中男女比例为1.37∶1。头面部BCC发生率最高占90.15%,病理分型中结节囊肿型66.7%,浅表型14.29%。在临床与病理符合率的比较中,头面部最高(86.34%)四肢最低(45.45%),色素型符合率66.7%。复发病例中以鼻部及眶周最多占56.25%,且病理分型中硬斑病样型占31.25%。结论基底细胞癌中,中青年患者占有一定比例,性别比例与老年患者不同;头面部为基底细胞癌的高发部位,病理分型中以色素型及浅表型误诊率高;临床中复发病例多发生在鼻部及眶周,硬斑病样型占较高比例;及时行病理活检对BCC的早期治疗、治疗方案的选择及预后至关重要。     

基底细胞癌75例临床病理分析

目的探讨皮肤基底细胞癌(BCC)组织病理特征及其鉴别诊断,以对治疗方案的选择提供指导。方法分析75例患者的临床及组织病理资料。结果按组织病理分型,实性BCC 33例,色素性BCC 14例,浅表性BCC 8例,硬斑病样BCC 5例,囊性BCC 3例,角化性BCC 4例,腺样BCC 2例,纤维上皮瘤性BCC 2例,实体与其他混合型4例。以上各型易与脂溢性角化病、光线性角化病、色痣、角化棘皮瘤、黑素细胞瘤、Bowen病等鉴别。结论各型皮肤基底细胞癌均具有明确的组织病理学特征,易与其他皮肤疾病鉴别。外科手术仍为首选治疗,Mohs显微外科手术在预防复发和美观方面更具优势,光动力疗法对表浅型BCC疗效较佳。     

Clinical and histopathological characteristics of basal cell carcinoma in Korean patients.

Seventy-eight Korean patients with basal cell carcinoma (BCC) between 1984 and 1998 were retrospectively examined at Ewha Womans University Tongdaemun Hospital, Seoul, Korea. We analyzed the annual incidence, age and sex distribution, site of the lesions, clinical appearance, including the proportion of clinically pigmented tumors, modalities of treatment, incidence of recurrence and metastasis of the tumors, the histopathological patterns, and whether solar elastosis, microscopic pigmentation, or adamantinoid feature were associated. The male-to-female ratio was 0.902, and the average age of the patients at first examination was 58.2 years. Eighty percent of the tumors occurred on the head and neck, most commonly on the nose (26.9%), followed by the cheek, eyelid, and upper lip. Ulcerated nodules were the most common clinical presentation. Clinically, 55% of the tumors were pigmented. Six tumors recurred; none metastasized. Surgical excision was the most common modality of treatment. The most frequent histopathological pattern was the solid type (60.3%), followed by the superficial (11.5%) and fibrosing (9.0%) types. The occurrence of the superficial type was significantly associated with truncal lesions (p < 0.001). Solar elastosis was present in 62.1% of the tumors on the head and neck, compared with 8.3% in those of the trunk and limbs (p < 0.001), indicating the significance of sun exposure in the pathogenesis of BCC on exposed areas. Microscopic pigmentation was seen in 69.2% of the tumors. The focal adamantinoid feature was found in 14.1%, which is much higher than the previously reported incidence.     

Correlation between the dermatoscopic and histopathological features of pigmented basal cell carcinoma

Background Dermatoscopy has a great value in the diagnosis of pigmented basal cell carcinoma (BCC), which is a clinical variant of BCC. The precise definitions of histopathological correlates of dermatoscopic features observed in pigmented BCC have not been established yet. Objective The present study aimed to investigate the correlation between the dermatoscopic features of pigmented BCC and their histopathological counterparts to provide clear histopathological definitions of each dermatoscopic feature. Methods In this case series that comprised a methodological component, after the orientation of dermatoscopic features was determined by placing sutures in the lesions, the histopathological counterparts of each were examined and definitions were made accordingly. Results Although the most common histopathological subtype of BCC is the solid type, the most common histopathological subtype observed in the pigmented BCC lesions in the present study was the superficial multifocal type (72.5%). Blue‐whitish veil was observed in 57.5% (n = 23) of the lesions, a percentage higher than that reported in the literature. In addition to confirming the previously histopathologically defined dermatoscopic features of pigmented BCC, we identified three histopathologically undefined features of pigmented BCC that are spoke‐wheel areas, large blue‐grey ovoid nests and multiple blue‐grey globules. Conclusion Dermatoscopy facilitates prediction of the corresponding histopathological findings in pigmented BCC, based on specific dermatoscopic features.     

Trends in the incidence of basal cell carcinoma by histopathological subtype

Background As a result of the high prevalence, basal cell carcinoma (BCC) causes a significant and expensive health care problem. Objective In this study, we evaluate the proportional increase in BCC by histological subtype over the last two decades. Methods We retrospectively reviewed all primary histological confirmed BCCs diagnosed in the Maastricht University Medical Centre in The Netherlands in the years 1991, 1999 and 2007. Results An annual increase of the number of BCCs of 7% for both genders was shown. The age‐standardized incidence rates for BCC increased between 1991 and 2007 from 54.2 to 162.1 per 100 000 men and from 61.7 to 189.8 per 100 000 women. The proportion of superficial BCC increased significantly from 17.6% to 30.7%. Conclusion The incidence of BCC is continuing to increase this century. The observed shift to the superficial histological subtype, which can be treated non‐surgically, might reduce the workload in the busy dermatologists practice.     

痣样基底细胞癌综合征一例

痣样基底细胞癌综合征是一种罕见的常染色体显性遗传病,以泛发性皮肤基底细胞癌和多器官发育异常为主要临床特征。本文报告1例痣样基底细胞癌综合征患者,并结合相关文献对该病的发病率、发病机制、诊断标准、治疗方法等进行讨论。     

色素性基底细胞癌一例

患者女,67岁.主因左耳后皮疹20年,溃烂2年余就诊.患者自述20年前左耳后长出一绿豆大小皮肤色丘疹,无自觉症状,数年后丘疹略增大,表面变粗糙,当地医院诊断刺瘊,自行数次用头发捆勒祛除之,未见效,皮疹增长缓慢无不适感.近5年常令其子用烟头烫,2年来丘疹反复糜烂、渗液、结痂,基底渐增大,色变黑,皮疹增大至鸽卵大小,中心溃烂不愈,无痛、痒感.     

Clinical and histopathological characteristics of extra‐facial basal cell carcinoma: Analysis of 35 patients at the Chonbuk National University Hospital in Korea

Basal cell carcinoma (BCC) primarily develops in the head and neck region, with 74–83 per cent of BCC occurring in this region. Unfortunately, most published studies on BCC were conducted in Caucasian populations, and analytic data on extra‐facial BCC in Asian and Korean patients, in particular, are not readily available. Here, we report on a retrospective analysis of extra‐facial BCC in Korean patients. Thirty‐five patients (16 men, 19 women) diagnosed with extra‐facial BCC at Chonbuk National University Hospital between January 1981 and December 2008 were evaluated. Their average age was 62.3 years and most of the patients (11 of 35, 31%) were in their fifties. The relative tumour density (RTD) was the highest in the genitalia (0.769), followed by the axilla (0.481). Other regions such as the trunk, buttocks and upper and lower extremities exhibited a much lower RTD (average: 0.1). Histopathological examinations showed that 16 tumours were nodular (46%), eight were superficial (23%) and seven were mixed (20%). Additionally, potential predisposing factors were identified in seven cases. In five patients the use of Asian medicine, including acupuncture and herbal medication, was ascertained. To the best of our knowledge, the present study is the first to analyse the clinical and histopathological characteristics of extra‐facial BCC in Korean patients. Our results indicate that the incidence of extra‐facial BCC is higher in the axilla and genitalia than at other locations, although these sites are frequently overlooked during routine skin examinations.     

Treatment of basal cell carcinoma

Basal cell carcinoma is the most common tumor in Central Europe, the U.S. and Australia. The increasing incidence of basal cell carcinoma presents the health care system, especially dermatology, with great challenges. In recent years new options for treating basal cell carcinoma have become available, enriching our therapeutic options. We review the current status of each of these treatment approaches.     

多发性基底细胞癌的皮肤镜特点

目的:明确多发性基底细胞癌的皮肤镜特点。方法:回顾性分析行皮肤镜检查并经组织病理确诊为基底细胞癌的7例多发性基底细胞癌患者的25处皮损。结果:皮损表现为散在血管模式20处,无血管模式5处;蓝灰色卵圆巢21处,多发性蓝灰色点及小球16处,不典型血管15处,无结构区13处,色素减退12处,线性毛细血管扩张11处,出血/溃疡11处,枫叶状结构10处,螺旋状血管10处,分支状血管7处,乳红色小球7处,红白背景下无结构区7处,逗号样血管5处,乳红色小点4处,轮幅样结构2处。结论:多发性基底细胞癌皮肤镜常见表现为散在血管模式,蓝灰色卵圆巢及多发性蓝灰色点及小球。     

Keratotic basal cell carcinoma of the upper eyelid

A 62 year old woman presented with two large slowly growing pedunculated tumours. These were excised from the lateral aspect of the upper eyelid and were found to be keratotic basal cell carcinomas.