黏液性汗管化生临床病理观察

发布时间：2018-05-23 20:05

本文选题：黏液性汗管化生 + 黏液　；参考：《诊断病理学杂志》2014年04期

【摘要】：目的探讨黏液性汗管化生的临床病理特点、诊断和鉴别诊断。方法对1例黏液性汗管化生进行组织学、组织化学和免疫组化分析,并复习相关文献。结果患者男性,46岁,因右侧外踝部包块伴瘙痒及黏液间断渗出1年余,而行包块切除术。镜下病变处表皮呈乳头状增生,部分区域表皮明显向下内陷,内陷浅表处被覆鳞状上皮,最深处则衬覆杯状细胞样的空泡细胞和鳞状上皮;内陷的表皮不与毛囊、汗腺和皮脂腺相连。组织化学PAS染色空泡细胞阳性。免疫组化示空泡细胞CK、EMA、pCEA和MUC5AC(+),但鳞状细胞MUC5AC(-);病变细胞GCDFP-15、MUC2、HMB45和S-100蛋白(-)。结论黏液性汗管化生是一种罕见的皮肤病变,临床上易与多种疾病混淆,根据其独特的组织学特征并结合免疫标记可作出正确诊断。
[Abstract]:Objective to investigate the clinicopathological features, diagnosis and differential diagnosis of mucinous sweat canal metaplasia. Methods A case of mucinous sweat canal metaplasia was analyzed by histology, histochemistry and immunohistochemistry. Results the patient was 46 years old. The right lateral malleolus was resected for more than one year due to itching and intermittent exudation of mucus. Under microscope, the epidermis of the lesion was papillary hyperplasia, some of the epidermis were obviously invaginated downward, the superficial surface of the invagination was covered with squamous epithelium, the deepest part was lined with goblet cell like vacuolar cells and squamous epithelium, the invaginated epidermis did not correspond to the hair follicle. Sweat glands connect with sebaceous glands. The vacuolar cells were positive by histochemical PAS staining. Immunohistochemistry showed that the vacuolar cells had EMA-pCEA and MUC5AC, but the squamous cells were MUC5AC-HMB45 and S-100, and the pathological cells were GCDFP-15, MUC2HMB45 and S-100 proteins. Conclusion the mucinous perineal metaplasia is a rare skin lesion, which is easily confused with many diseases in clinic. The correct diagnosis can be made according to its unique histological features and combined with immunological markers.
【作者单位】：芜湖市第五人民医院病理科;南京市第一医院病理科;
【分类号】：R739.5

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