多发性皮肤鳞状细胞癌1例

患者男,82岁。左胫前皮肤局限性斑块伴痒20余年,结节破溃两年。患者20余年前左胫前出现一局限性斑块,表面有鳞屑,伴瘙痒,外院以"神经性皮炎"予外用药物及局部封闭治疗,皮损未消退。后反复搔抓刺激,搔抓后破溃、结痂,逐渐相继形成两个结节。未发现全身其他器官转移。皮损组织病理示:两结节均显著角化过度,角化不全,浅表糜烂、结痂,真皮内可见鳞状上皮岛伴中央角化,边缘少量异型细胞,病理性核分裂相多见,可见角珠形成。诊断:多发性皮肤鳞状细胞癌。

A Case of Multiple Cutaneous Squamous Cell Carcinomas

An 82-year-old man presented with a localized plaque on the shin with itching for more than 20 years,and the nodules ulcerated for two years.The initial lesion was a localized plaque with scales and pruritus on the left shin of the patient.It was be diagnosed as "Neurodermitis" on other hospitals and be treated with topical drugs and blockage,but the lesion didn′t diminish.With intense scratching,the lesion ulcerated and formed a scab.Then,two nodules arose on the plaque one after another.With intense scratching,two nodules arose on the plaque lesions one after another.No neoplasm metastasis could be found.Histopathological examination revealed:both of two nodules were hyperkeratosis and parakeratosis with erosion and crust.In dermis,there were some squamous epithelium islands with keratinization in center.Around these islands,there were some cells with atypia and abnormal karyokinesis.Some keratin pearls could be seen.Diagnosis:multiple cutaneous squamous cell carcinoma.