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报告1例恶性增生性甲外毛根鞘样囊肿。患者男,78岁。右手拇指指甲增厚、破溃30年,伴疼痛。组织病理检查见甲床下方大量囊肿样的肿瘤细胞团块,瘤细胞为鳞状上皮,异形性明显,中央可见毛鞘样角化,未见颗粒层,可见透明细胞,瘤细胞未侵入指骨。免疫组化结果显示肿瘤细胞CK1阳性,CK6阳性,CK10部分阳性,CK7阴性、CK15阴性、Ki-67增殖指数约20%。结合临床、组织病理及免疫组化结果诊断为恶性增生性甲外毛根鞘样囊肿。
Report of 1 case of malignant hyperplasia of A hair root sheath cyst. Male patient, 78 years old. Thickened right thumb nails, ruptured 30 years, with pain. Histopathological examination showed a large number of cyst-like tumor cell masses below the nail bed. The tumor cells were squamous epithelium with obvious atypia. The hair-sheath-like keratosis at the center showed no granular layer. The transparent cells and the tumor cells did not invade the phalanges. The results of immunohistochemistry showed that CK1 was positive, CK6 was positive, CK10 was partly positive, CK7 was negative, CK15 was negative, Ki-67 proliferation index was about 20%. Combined with clinical, histopathological and immunohistochemical results of the diagnosis of malignant hyperplasia of Aneurysm sheath-like cysts.