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报告1例远端型上皮样肉瘤。患者男,20岁。左足小趾疣状增生结节伴疼痛半年,左大腿下段外侧红斑5个月。皮损组织病理检查:表皮乳头瘤样增生伴角化过度,真皮层中央坏死,周围有较多上皮样和梭形肿瘤样细胞不规则排列;间质有慢性炎性细胞浸润,可见多核巨细胞。肿瘤细胞免疫组化检查示细胞角蛋白(CK)(+)、波形蛋白(vimtin)(++)、上皮膜抗原(EMA)(+)、Lys(+)、CD68(+)、平滑肌肌动蛋白(SMA)灶性(+)、增殖细胞核抗原(Ki)-67 3%(+)、CD34(-)、CD31(-)、结蛋白(desmin)(-)、黑素瘤抗体(HMB)-45(-)、S-100蛋白(-)、恶性黑素瘤(melanoma)(-)。结合临床表现、皮肤组织病理及免疫组化结果,诊断上皮样肉瘤。
One case of distal epithelioid sarcoma was reported. Patient male, 20 years old. Left foot small toe verrucous hyperplasia nodules with pain for six months, left lateral thigh erythema 5 months. Histopathological examination of skin lesions: epidermal papilloma-like hyperplasia with hyperkeratosis, central dermis necrosis, more epithelial-like and spindle-shaped tumor-like cells around irregularly arranged; interstitial infiltration of chronic inflammatory cells, showing multinucleated giant cells . Tumor cell immunohistochemistry showed cytokeratin (+), vimtin (++), epithelial membrane antigen (EMA) (+), Lys (+), CD68 (+), CD34 (-), CD31 (-), desmin (-), melanoma antibody (HMB) -45 (-), S-100 protein (-), melanoma (-). Combined with clinical manifestations, skin histopathology and immunohistochemical results, diagnosis of epithelioid sarcoma.