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目的探讨乳头状汗腺瘤的临床病理特征、诊断与鉴别诊断。方法对10例乳头状汗腺瘤的临床病理特征和免疫组化表型分析。结果本组女性9例,男性1例,年龄31~65岁,平均44岁,9例位于外阴和肛周,1例位于肩颈部;临床表现为单发丘疹或界限清楚的皮下结节,直径0.5~2 cm;组织学上见肿瘤由大小不一的腺管和相互吻合的乳头状结构组成,被覆双层上皮,内层为高柱状的上皮细胞,可见顶浆分泌,外层为梭形或矮立方的肌上皮细胞。免疫组化显示:所有肿瘤的内层柱状细胞均ER、PR、CK和EMA(+),9例CK34βE12和CK7(+),3例AR和GCDFP-15(+),1例CK20(+),所有肿瘤肌上皮细胞均p63和S-100(+),7例肿瘤双层上皮CK5/6同时(+),Ki-67增值指数从1%~60%不等。结论乳头状汗腺瘤是一种少见的发生于肛周生殖器的皮肤良性肿瘤,个别肿瘤可发生癌变,因临床表现多变,极易误诊,通过组织活检可确诊。肿瘤完整切除后预后良好。
Objective To investigate the clinical and pathological features, diagnosis and differential diagnosis of papillary adenoma. Methods The clinicopathological features and immunohistochemical phenotypes of 10 cases of papillary adenoma were analyzed. Results The group of 9 females, 1 males, aged 31 to 65 years, mean 44 years old, 9 cases located in the vulva and perianal and 1 case located in the shoulder and neck; clinical manifestations of single papules or well-defined subcutaneous nodules, Diameter of 0.5 ~ 2 cm; histologically see the tumor by the size of the duct and nipple-like structure of mutual agreement, covered bilayer epithelial, the inner columnar epithelial cells, visible apocrine secretion, the outer shuttle Shaped or dwarf myoepithelial cells. Immunohistochemistry showed that ER, PR, CK and EMA (+), 9 cases of CK34βE12 and CK7 (+), 3 cases of AR and GCDFP-15 (+) and 1 case of CK20 , All the tumor myoepithelial cells were p63 and S-100 (+), 7 cases of tumor double epithelial CK5 / 6 at the same time (+), Ki-67 value-added index ranging from 1% to 60%. Conclusion Nipple papillary adenoma is a rare benign tumor of the skin that occurs in the perianal genital area. Carcinoma may occur in some tumors. Due to the variable clinical manifestations, it is easily misdiagnosed and confirmed by tissue biopsy. After complete tumor resection, the prognosis is good.