Sebaceous carcinoma of the eyelids: Thirty cases from Japan
Sebaceous carcinoma of the eyelids: Thirty cases from Japan
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DOI：
10.1111/j.1440-1827.2008.02260.x
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发表时间：
2008-08-01
影响因子：
2.2
通讯作者：
Goto, Hiroshi
中科院分区：
文献类型：
--
作者：
Izumi, Miki;Mukai, Kiyoshi;Goto, Hiroshi
眼睑的皮脂腺癌在西方国家很少见，但在亚洲国家并不少见。诊断是困难的临床和组织学。本文回顾了东京医科大学附属医院收治的30例眼睑皮脂腺癌的病理表现。肿瘤细胞呈小叶状浸润，主要由大的非典型生发细胞组成。小叶内的皮脂腺细胞有明显的核仁和核仁周晕。17例（57%）瘤巢内及周围有泡沫样组织细胞浸润。24例（80%）出现皮脂腺管分化，即全分泌物，表明一种特定类型的凝固性坏死，维持细胞框架或维持与周围核碎片相关的泡状细胞质。虽然明确的鳞状细胞分化仅限于11例癌，但29例（96.7%）出现了在生发细胞背景中的散在单个坏死伴核碎片。所有病例均检测到上皮膜抗原、围脂蛋白和亲脂蛋白的表达。因此，在检测皮脂腺癌中的皮脂腺分化时，关注全分泌、鳞状分化和泡沫巨噬细胞浸润，并利用包括抗perilipin和抗adipophilin染色的免疫组化将是有帮助的。
Sebaceous carcinoma of the eyelids is rare in Western countries but not uncommon in Asian countries. Diagnosis is difficult both clinically and histologically. Thirty cases of sebaceous carcinoma of the eyelids treated at Tokyo Medical University Hospital were reviewed to elicit characteristic features of pathological findings. The tumor cells were infiltrating in a lobular pattern that consisted mainly of large atypical germinative cells. Sebocytes seen in the lobules had conspicuous nucleolus associated with perinucleolar halo. In 17 cases (57%) there was foamy histiocyte infiltration in and around the tumor nests. Sebaceous duct differentiation, namely holocrine secretion indicating a specific type of coagulation necrosis maintaining a cellular framework or maintaining a bubbly cytoplasm associated with nuclear debris in the periphery, was seen in 24 cases (80%). Although unequivocal squamous differentiation was limited to only 11 carcinomas, scattered individual necrosis with nuclear debris in the background of germinative cells appeared in 29 cases (96.7%). Expression of epithelial membrane antigen, perilipin and adipophilin were detected in all cases. In conclusion, to detect sebaceous differentiation in sebaceous carcinoma, it would be helpful to focus on holocrine secretion, squamous differentiation and foamy macrophage infiltration, and to utilize immunohistochemistry involving anti-perilipin and anti-adipophilin stain.