肾上腺皮质癌皮肤转移1例国内首报

发布时间：2018-01-09 07:40

本文关键词：肾上腺皮质癌皮肤转移1例国内首报　出处：《中国皮肤性病学杂志》2015年04期 　论文类型：期刊论文

【摘要】：目的探讨肾上腺皮质癌(ACC)皮肤转移的临床表现、病理学特点及诊断,提高对本病的认识。方法分析1例ACC皮肤转移的临床表现、组织病理及免疫组织化学,复习相关文献并进行讨论。结果患者右臀部肿物进行性增大伴轻度疼痛1月余。ACC行腹腔镜下左肾上腺区肿瘤切除术2年。皮肤科情况:右臀部为一直径约5cm近圆形暗红色肿块,局部皮温略高,质地硬,境界较清楚,压痛明显。肿块组织病理示:真皮内可见境界清楚的肿瘤细胞团块,细胞核大,圆形或椭圆形,呈不典型性,有核丝分裂相,胞浆丰富呈嗜酸性或淡染;免疫组织化学染色示:肿瘤细胞Synaptophysin,Vimentin强阳性;Calretinin,Inhibin阳性;Chromogranin A,SMA,CD10,CK,S100,HMB45,Melan A,Desmin,CEA均阴性。结合免疫组织化学和病史,符合ACC皮肤转移。结论 ACC皮肤转移国内尚未见报道,国外罕有报道。组织病理及免疫组织化学对本病的诊断及鉴别诊断有重要作用。
[Abstract]:Objective to investigate the clinical manifestations, pathological features and diagnosis of skin metastasis of adrenal cortical carcinoma (ACC), and to improve the understanding of this disease. Methods the clinical manifestations of 1 case with ACC skin metastasis were analyzed. Histopathology and immunohistochemistry. Results the patients with progressive enlargement of the right buttocks with mild pain in January underwent laparoscopic resection of the left adrenal area tumor for 2 years. Dermatology:. The right buttocks were a dark red mass about 5 cm in diameter. The local skin temperature was slightly higher, the texture was hard, the boundary was clear, and the tenderness was obvious. Histopathology of the tumor showed that the tumor cell mass with clear boundary could be seen in the dermis, the nucleus was large, round or oval, and it was atypical. There was mitotic phase and the cytoplasm was rich in eosinophilic or light staining. Immunohistochemical staining showed that the tumor cells were strongly positive for Synaptophysinia sinustii vimentin (Vimentin). Calretinin Inhibin positive; Chromogranin A,SMA,CD10,CK,S100,HMB45,Melan A,Desmin. CEA was negative. Combined with immunohistochemistry and history, it was consistent with ACC skin metastasis. Conclusion ACC skin metastasis has not been reported in China. It is rarely reported abroad. Histopathology and immunohistochemistry play an important role in the diagnosis and differential diagnosis of this disease.
【作者单位】：首都医科大学附属北京朝阳医院西区皮肤科;
【分类号】：R736.6;R739.5
【正文快照】： 肾上腺皮质癌(adrenocortical carcinoma,ACC)是一种罕见的肿瘤,发生皮肤转移则更为罕见。迄今为止,国外文献报道4例(NCBI检索),国内未见文献报道。本文报道1例ACC皮肤转移,分析其临床病理学特点并复习相关文献。1临床资料患者男,43岁,汉族。右臀部肿物进行性增大伴轻度疼痛1

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