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目的:分析良恶性增生性外毛根鞘囊肿(PTC/MPTC)的临床表现、组织病理特点及鉴别诊断。方法:采用回顾性分析方法对3例良性增生性外毛根鞘囊肿(PTC),1例恶性增生性外毛根鞘囊肿(MPTC)的临床及组织病理资料进行分析。结果:3例PTC均发生于头部,1例MPTC发生于下颌部,临床上4例患者均表现为头面部肤色或暗红色结节。组织病理上PTC表现为外毛根鞘型角化的囊肿形成多小叶结构。MPTC往往生长较快,容易出现坏死,如果在PTC的病理基础上,出现明显的细胞异形性和坏死,说明PTC出现了恶性转化。结论:对于头面部肤色或暗红色结节,组织病理是明确诊断的关键,对于MPTC,侵袭性生长模式,局灶性的坏死及明显的细胞异形性是诊断的关键。外毛根鞘来源的外毛根鞘囊肿、PTC,MPTC是一个谱系性疾病。是一个由良性到恶性连续的形态学谱系。
Objective: To analyze the clinical manifestations, histopathological features and differential diagnosis of benign and malignant proliferative root hair sheath cyst (PTC / MPTC). Methods: The clinical and histopathological data of 3 patients with benign prostatic hyperplasia (PTC) and 1 with malignant extrinsic root hair sheath (MPTC) were analyzed retrospectively. Results: 3 cases of PTC occurred in the head, 1 case of MPTC occurred in the lower jaw, 4 cases of clinical manifestations of head and face complexion or dark red nodules. Tissue pathology of PTC showed the outer root sheath keratinized cyst formation of multilobular structure. MPTC tend to grow faster, prone to necrosis, if the pathological basis of PTC, significant cellular atypia and necrosis, indicating that malignant transformation of PTC. Conclusion: Histopathology is the key to confirm the diagnosis of head and facial skin color or dark red nodules. For MPTC, invasive growth pattern, focal necrosis and obvious cell atypia are the keys to diagnosis. External hair root sheath derived from the outer root sheath cyst, PTC, MPTC is a lineage disease. Is a morphological lineage that goes from benign to malignant.