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患者女,49岁。外阴丘疹渐增大2年余。皮肤科检查:外阴左侧一直径约1.0 cm灰白色、半透明、近半球形结节,表面光滑,质地硬。皮损组织病理:真皮内一境界清楚的单房囊腔,其外纤维性假包膜,腔内充以大量乳头状结构,囊腔壁及乳头状结构主要为肌上皮细胞及高柱状细胞,有顶浆分泌,乳头内有少量纤维血管间质;免疫病理:肌上皮细胞平滑肌肌动蛋白(SMA)及S-100蛋白阳性,内层细胞细胞角蛋白(CK)及极低分子量角蛋白(CAM5.2)阳性,内层细胞上皮膜抗原(EMA)阳性。诊断:大汗腺乳头状囊腺瘤。
Female patient, 49 years old. Vulvar rash gradually increased more than 2 years. Dermatology examination: a diameter of about 1.0 cm on the left side of the vulva gray, translucent, nearly hemispherical nodules, smooth surface, hard texture. Histopathology: a clear single-compartment cyst in the dermis, the outer fibrous pseudocapsule, the cavity filled with a large number of papillary structures, cyst wall and papillary structures are mainly myoepithelial cells and high columnar cells, There is a small amount of fibrovascular stroma in the nipple. Immunopathology: Positive SMA and S-100 protein in the myoepithelial cells, cytokeratin (CK) in the cytoplasm and very low molecular weight keratin CAM5.2) positive, inner membrane epithelial membrane antigen (EMA) positive. Diagnosis: apocrine papillary cystadenoma.