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目的探讨原发性皮肤黏液癌的临床病理学特点及预后。方法应用光镜观察、免疫组化等方法对2例原发性皮肤黏液癌进行分析,并复习相关文献。结果皮肤原发性黏液癌生长缓慢,病程常为数年甚至数十年。组织学上,肿瘤主要位于真皮层,并常累及皮下脂肪组织,癌细胞团块呈岛状漂浮在淡染的黏蛋白湖中,周围由纤细的纤维将其分隔;癌细胞为立方形、圆形或卵圆形,胞质丰富,淡红染,细胞核圆形或卵圆形,居中,核分裂象少见。免疫组化:癌细胞CK7、ER、PR、CEA和GCDFP-15(+),CK20、CDX-2、CA125,TTF1、c-erbB-2、PSA和villin均(-),Ki-67低表达(通常<5%)。结论原发于皮肤的黏液癌罕见,组织学上与转移性黏液癌鉴别困难,须结合临床及免疫组化标记排除转移癌后方可诊断。该肿瘤恶性度低,治疗主要采用手术切除肿瘤,预后较好。
Objective To investigate the clinicopathological characteristics and prognosis of primary cutaneous mucinous carcinoma. Methods Two cases of primary cutaneous mucinous carcinoma were analyzed by light microscopy and immunohistochemistry, and the related literatures were reviewed. The results of skin mucoepidermoid growth slow, the course of several years or even decades. Histologically, the tumor is mainly located in the dermis, and often involving the subcutaneous adipose tissue, the tumor cell mass is floating in the lightly stained mucins lake surrounded by thin fibers; cancer cells are cubic, round Shaped or ovoid, rich in cytoplasm, pink stained, round or oval nucleus, centered, mitotic rare. Immunohistochemistry: The expression of Ki-67 in CK7, ER, PR, CEA and GCDFP-15 (+), CK20, CDX- 2, CA125, TTF1, c-erbB- (Usually <5%). Conclusions Primary mucinous carcinoma of the skin is rare and difficult to differentiate histologically from metastatic mucinous carcinoma. It should be diagnosed by combining clinical and immunohistochemical markers to exclude metastatic carcinoma. The malignancy of the tumor is low, the treatment is mainly surgical removal of the tumor, the prognosis is good.