眼眶高增殖活性毛母质瘤1例临床病理观察(1)
【摘要】 目的：探討眼眶高增殖活性毛母质瘤临床病理学特征、免疫表型、鉴别诊断、治疗及预后。方法：收集1例发生于右眼眶的高增殖活性毛母质瘤临床资料，观察其病理学形态及免疫表型。结果：患者男性，56岁，以右眼眶上肿物2个月余为主要症状，肉眼观眉弓处5 mm×
4 mm×2 mm大小肿物隆起，边界尚清。镜下观察病变位于真皮层，大部分瘤细胞为小的基底样细胞构成的实性巢状结构，细胞巢周围见疑似收缩间隙，该类细胞圆形或卵圆形，细胞质少，细胞核染色质较均匀，可见小核仁，核分裂象多，20个/10 HPF；部分区域见小灶角化物，见一处基底样细胞突然角化，形成鬼影细胞。免疫组化示基底样肿瘤细胞Ki-67(+，60%)，Bcl-2、CD10、P53、EMA、CK-P(+)，AR、HMB45、Melan A、CEA(-)。术后随访10个月，无复发。结论：眼眶高增殖活性毛母质瘤少见，需与基底细胞癌、恶性黑色素瘤、毛母质癌等鉴别，特别是当表现为肿瘤细胞增殖活性高，鬼影细胞数量少时，其确诊需结合临床病史、病理组织学及免疫组化等信息进行综合分析。
【关键词】 毛母质瘤； 病理特征； 鉴别诊断
doi：10.14033/j.cnki.cfmr.2018.17.090 文献标识码 B 文章编号 1674-6805(2018)17-0-03
Clinicopathological Observation of One Case Pilomatricoma of High Hyperplasia Activity in Orbit/QIN Xingshan，PAN Yunying，YANG Dezhi，et al.//Chinese and Foreign Medical Research，2018，16(17)：-188
【Abstract】 Objective：To investigate the clinicopathological features，immunohistochemical characteristics，differential diagnosis，treatment and prognosis of pilomatricoma of high hyperplasia activity in orbit.Method：Pilomatrixoma of high hyperplasia activity of one case in the right orbit was collected.The pathological morphology and immunophenotype were observed.Result：The male patient was 56 years old，with a right supraorbital mass for more than 2 months as the main symptom.There was a 5 mm×4 mm×2 mm tumor mass at the eyebrow and the boundary was clear.The lesion was located in the dermis.Most of the tumor cells were small basal-like cells composition of a solid nested structure.The suspected contraction of space appeared around nested structure and these cells were round or oval，cytoplasmic less and nuclear staining was relatively uniform，showing small nucleoli，mitosis as much (20 mitosis/10 HPF).There were part of the area，focal keratosis and a sudden basification of basal-like cells，forming ghosting cells.Immunohistochemistry showed those the basal-like tumor cells were positive for Ki-67(60%)，Bcl-2，CD10，P53，EMA，CK-P and negative for AR，HMB45，Melan A，CEA.The patient was followed up for 10 months without recurrence.Conclusion：High proliferative orbital pilomatricoma is rare and needs to be differentiated from basal cell carcinoma，malignant melanoma and hairymacular carcinoma.Diagnosis shall be combined with clinical history，histopathology and immunohistochemistry for a comprehensive analysis，especially when the tumor cell proliferative activity is high and the number of ghost cells is small.
【Key words】 Pilomatricoma； Clinicopathological features； Differential diagnosis, http://www.100md.com(覃兴善 潘运迎 杨得志 陈柳红)
4 mm×2 mm大小肿物隆起，边界尚清。镜下观察病变位于真皮层，大部分瘤细胞为小的基底样细胞构成的实性巢状结构，细胞巢周围见疑似收缩间隙，该类细胞圆形或卵圆形，细胞质少，细胞核染色质较均匀，可见小核仁，核分裂象多，20个/10 HPF；部分区域见小灶角化物，见一处基底样细胞突然角化，形成鬼影细胞。免疫组化示基底样肿瘤细胞Ki-67(+，60%)，Bcl-2、CD10、P53、EMA、CK-P(+)，AR、HMB45、Melan A、CEA(-)。术后随访10个月，无复发。结论：眼眶高增殖活性毛母质瘤少见，需与基底细胞癌、恶性黑色素瘤、毛母质癌等鉴别，特别是当表现为肿瘤细胞增殖活性高，鬼影细胞数量少时，其确诊需结合临床病史、病理组织学及免疫组化等信息进行综合分析。
【关键词】 毛母质瘤； 病理特征； 鉴别诊断
doi：10.14033/j.cnki.cfmr.2018.17.090 文献标识码 B 文章编号 1674-6805(2018)17-0-03
Clinicopathological Observation of One Case Pilomatricoma of High Hyperplasia Activity in Orbit/QIN Xingshan，PAN Yunying，YANG Dezhi，et al.//Chinese and Foreign Medical Research，2018，16(17)：-188
【Abstract】 Objective：To investigate the clinicopathological features，immunohistochemical characteristics，differential diagnosis，treatment and prognosis of pilomatricoma of high hyperplasia activity in orbit.Method：Pilomatrixoma of high hyperplasia activity of one case in the right orbit was collected.The pathological morphology and immunophenotype were observed.Result：The male patient was 56 years old，with a right supraorbital mass for more than 2 months as the main symptom.There was a 5 mm×4 mm×2 mm tumor mass at the eyebrow and the boundary was clear.The lesion was located in the dermis.Most of the tumor cells were small basal-like cells composition of a solid nested structure.The suspected contraction of space appeared around nested structure and these cells were round or oval，cytoplasmic less and nuclear staining was relatively uniform，showing small nucleoli，mitosis as much (20 mitosis/10 HPF).There were part of the area，focal keratosis and a sudden basification of basal-like cells，forming ghosting cells.Immunohistochemistry showed those the basal-like tumor cells were positive for Ki-67(60%)，Bcl-2，CD10，P53，EMA，CK-P and negative for AR，HMB45，Melan A，CEA.The patient was followed up for 10 months without recurrence.Conclusion：High proliferative orbital pilomatricoma is rare and needs to be differentiated from basal cell carcinoma，malignant melanoma and hairymacular carcinoma.Diagnosis shall be combined with clinical history，histopathology and immunohistochemistry for a comprehensive analysis，especially when the tumor cell proliferative activity is high and the number of ghost cells is small.
【Key words】 Pilomatricoma； Clinicopathological features； Differential diagnosis, http://www.100md.com(覃兴善 潘运迎 杨得志 陈柳红)