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患者男,39岁。右侧鼻腔新生物3月余,鼻背肿物1月。查体见鼻背偏右类圆柱样新生物,直径约4.0cm,高约3.0cm,顶端中央形成“火山口”样溃疡,边缘见角化物,右侧鼻腔半颗花生米大小新生物,表面粗糙,质脆。鼻窦CT及电子鼻咽喉镜检查示:鼻腔肿物主要位于右侧鼻阈,半颗花生米大小,颈部淋巴结彩色超声未见异常。术中切除物组织病理示:肿瘤团块呈半球形隆出皮肤表面,中央火山口样充满角质物,瘤体由较大、淡染的角质形成细胞组成,两侧的上皮细胞成抱球状,局部基底部见浸润生长的肿瘤细胞,瘤体下方真皮浅层内密集淋巴细胞为主的炎症细胞浸润。诊断:角化棘皮瘤。
Male patient, 39 years old. Right nasal newborn more than 3 months, nose and back in January. Check the body to see the back of the right class cylinder-like new biological diameter of about 4.0cm, about 3.0cm high, the top of the central formation of “crater” -like ulcers, the edge of the see keratosis, the right nasal half a peanut-sized new creatures , The surface is rough, crisp. Sinus CT and electronic nasopharyngeal laryngoscopy showed: nasal tumor is mainly located in the right nasal threshold, half a peanut size, cervical lymph node ultrasound was normal. Histopathology showed that the tumor mass showed a hemispherical outline of the skin surface, the central crater was filled with keratinized material, and the tumor body consisted of larger and lightly stained keratinocytes. The epithelial cells on both sides became spherical, See the infiltration of the growth of local basal part of the tumor cells, the dense dermis within the superficial layer of dense lymphocyte-based inflammatory cell infiltration. Diagnosis: Keratoacanthoma.