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原发性皮肤小细胞瘤,即Merkel细胞癌(或称皮肤小梁癌)。自1972年Toker首次报导以来,已经发现了50多例这种罕见的肿瘤。发生部位多见于面部、唇、四肢及臀部。肿物为紫红色生长缓慢的无痛性小结节,老年妇女多见,局部复发率36％,区域淋巴结转移率46％。Merkel细胞癌需与淋巴瘤,黑素瘤、低分化癌、转移性燕麦细胞癌及其他的原发或转移到皮肤的小圆形细胞肿瘤进行鉴别。但是,在常规染色及光镜下是无法区分的,常常需要电镜的帮助。为提供更客观的诊断标准作者用针对神经微丝(NF蛋白的单克隆抗体和对神经元特异的烯醇酶(NSE)特异的抗血清,以免疫组织化学的方法,对4例Merkel细胞癌病人进行了检查。结果3例NF蛋白免疫反应阳性、免疫反应发生于核旁,呈核旁球状体形,与集聚的中间微丝的超微结构的观察相一
Primary squamous cell tumor, Merkel cell carcinoma (or trabecular carcinoma). Since Toker first reported in 1972, more than 50 such rare tumors have been discovered. Occurs in the face more common in the face, lips, limbs and buttocks. The tumor was a slow-growing, painless nodule with purplish red color, which was more common in older women. The local recurrence rate was 36%, and the regional lymph node metastasis rate was 46%. Merkel cell carcinoma needs to be differentiated from lymphomas, melanomas, poorly differentiated cancers, metastatic acellular cancers, and other small round cell tumors that are primary or metastatic to the skin. However, it is indistinguishable from conventional staining and light microscopy, and often requires the help of an electron microscope. To provide more objective diagnostic criteria, the authors used immunohistochemistry for neurofilament (monoclonal antibody to NF protein and specific neurons specific enolase (NSE) antiserum to 4 cases of Merkel cell carcinoma The patient underwent an examination.Results Three cases of NF-protein immunoreactivity were positive and the immune reaction occurred near the nucleus, showing a parasaunal spheroid morphology, which was consistent with the observation of the ultrastructure of the aggregated microfilaments.