默克尔细胞癌为罕见的皮肤恶性肿瘤(附2例临床报告)

R. A. Ravodin, L. S. Kruglova, A. V. Nikitina
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引用次数: 0

摘要

本文就默克尔癌的流行、临床特点、皮肤镜、病理形态学诊断及治疗等方面的文献作一综述。根据所提供的数据,描述了我们自己对默克尔癌的两项临床观察:临床和皮肤镜描述,病理形态学和免疫组织化学图像,所进行的治疗及其长期结果。在目前的临床观察中,两名70岁和83岁的女性在I期发现了默克尔癌,这决定了良好的预后。临床表现为致密、无溃疡性结节或粉红色结节;所有肿瘤均局限于头部。皮肤镜下的照片则不同,在一个病例中,它是由红色的小球和圆点表示的,背景是乳白色和白色的区域,单个的线性和卷曲的血管,有白色的结构(如蛹),而在另一个病例中,粉红色的无结构区域有树状血管和白色的结构,如蛹。组织学上以小圆细胞型结构为主。两例患者的免疫组化研究均显示细胞角蛋白20和嗜铬粒蛋白a的显著表达,Ki - 67指数均在70%以上。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Merkel cell carcinoma as rare malignant skin tumor (two clinical cases)
This article provides a review of the literature on the prevalence of Merkel carcinoma, the features of its clinical, dermoscopic, pathomorphological diagnosis and therapy. In the light of the presented data, two of our own clinical observations of Merkel carcinoma are described: a clinical and dermoscopic description, a pathomorphological and immunohistochemical picture, the treatment performed and its long-term results are given. In the presented clinical observations, Merkel carcinoma was detected in two women aged 70 and 83 years at stage I, which determined a favorable prognosis. Clinically, the tumor was presented in the form of a dense, non-ulcerated nodule or a pink-red nodule; all neoplasms were localized on the head. The dermoscopic picture was different, in one case it was represented by globules and dots of red color against a background of milky pink and white areas, individual linear and convoluted vessels, there were white structures (like chrysalids), and in another case – structureless areas of pink color with tree-like vessels and white structures in the form of chrysalids. Histologically, the small round cell type of structure predominated. An IHC study in both cases revealed a pronounced expression of cytokeratin 20 and chromogranin A, the Ki‑67 index was above 70 %.
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