皮肤Merkel细胞癌2例报告及文献复习

目的:探讨皮肤 Merkel细胞癌的组织学及免疫组织化学表达特点及鉴别诊断。方法:对 2例皮肤Merkel细胞癌患者的临床病史、肿瘤组织的病理形态和免疫组化表达及相关文献进行了回顾性分析 ,比较 Merkel细胞癌和黑色素瘤在临床及病理形态等方面的异同。结果 :2例 Merkel细胞癌患者均表现为皮肤肿块 ,无淋巴结和内脏转移的证据 ;例 1曾有皮肤黑色素瘤切除后复发的病史。肿瘤细胞为单调、均匀一致的圆形细胞 ,胞质稀少 ,弥漫排列 ;免疫组化表达神经内分泌标志物和细胞角蛋白 2 0 (CK2 0 )。结论 :皮肤 Merkel细胞癌在形态上需与黑色素瘤、非霍奇金淋巴瘤和转移性小细胞癌等鉴别 ,免疫组化染色有助于皮肤 Merkel细胞癌的诊断和鉴别诊断。

Cutaneous Merkel cell carcinoma:2 cases report and literature review

Objective: To study histological,immumohistochemical expressive feature and differentiated diagnosis of cutaneous Merkel cell carcinoma. Methods: With review of the literature,the clinical history, histopathological changes and immunohistochemical expression were investigated and reviewed in 2 cases of Merkel cell carcinoma,comparing the similarities and differences in clinical course and pathomorphology between Merkel cell carcinoma and melanoma. Results: Two patients manifested cutaneous masses,no evidence of metastasis and involvement of regional lymph node and viscera;case 1 had a history of resection and recurrence of cutaneous melanoma. The tumors revealed monotonously uniform,small,round tumor cells arranged in solid sheets;the cells had round nuclei and scantly amphophilic cytoplasm,expressed neuroendocrine markers and CK 20 in immunohistochemical staining. Conclusions: Merkel cell carcinoma needs to be differentiated from melanoma,non-Hodgkin lymphoma and metastatic small cell carcinoma in histological appearance;immunohistochemical staining is useful for diagnosis and differentiation.