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患者女,76岁。左面颊部肿物1年,明显增大1个月。皮损特点为紫红色球形肿物。皮损组织病理示:表皮见团块状鳞状上皮中-重度异型增生,突破基底膜;真皮全层见形态一致的肿瘤细胞浸润,巢状或片状分布,圆形或卵圆形,胞质少、嗜碱性,核大、散点状分布染色质,核仁明显,可见多数核分裂相。免疫组化:CK20(部分+),P63及CKH(鳞状分化的细胞+),Syn(+),CgA(+),CD56(+),LCA(-),CK7(-),S100(-)。诊断:皮肤Merkel细胞癌伴鳞状细胞癌。
Female patient, 76 years old. Left cheek mass 1 year, significantly increased for 1 month. Skin lesions characterized by purple-red spherical tumor. Histopathological examination of the lesion showed that in the epidermis, medium-to-severe dysplasia of the massive squamous epithelium was found, which broke through the basement membrane. The full-thickness dermis showed morphologically normal infiltration of tumor cells, nests or flakes, round or oval, Quality less, basophilic, nuclear large, scattered distribution of chromatin, prominent nucleoli, showing the majority of mitotic phase. Immunohistochemistry showed that there was no significant difference in the expression of CK20 (partial +), P63 and CKH (squamous differentiated cells +), Syn (+), CgA +, CD56 +, LCA-, CK7-, ). Diagnosis: Merkel cell skin cancer with squamous cell carcinoma.