Histopathological diagnosis of epithelial crateriform tumors: Keratoacanthoma and other epithelial crateriform tumors
Histopathological diagnosis of epithelial crateriform tumors: Keratoacanthoma and other epithelial crateriform tumors
复制标题
DOI：
10.1111/1346-8138.13390
复制
发表时间：
2016-11-01
影响因子：
3.1
通讯作者：
Saeki, Hidehisa
中科院分区：
文献类型：
--
作者：
Ogita, Azusa;Ansai, Shin-ichi;Saeki, Hidehisa
角棘瘤（KA）是一种独特的临床病理实体，尽管人们经常混淆其与其他类型的样状肿瘤的区别。本研究对380例伴有中心角蛋白堵塞的表皮样状肿瘤的临床病理特征进行了复查，并将其组织学分为7种类型：(1)样状疣；（ii）标准样脂溢性角化病；(3)卡;（iv） KA伴常规鳞状细胞癌（SCC）成分（KA样SCC和KA伴恶性转化）；(v)沙状鲍文氏病；（vi）由太阳角化病引起的标准样鳞状细胞癌；（vii）漏斗状SCC的火山口形态。我们的研究证明，在KA病变中发生SCC的发生率为17.4%。发病率因患者年龄而异：70岁以下患者为8.3%，70岁及以上患者为24.3%。几乎所有的恶性沙状肿瘤（94.7%）发生在阳光照射的区域。面部病变包括KA 138例（59.5%），恶性沙样肿瘤65例（28%），良性沙样肿瘤29例（12.5%）。我们得出结论，KA不是SCC的一种变体，而是一种良性的、经常退行性增生性病变或交界性肿瘤，尽管KA有可能发生SCC。由于70岁及以上年龄的患者，KA病变中SCC的发生率和其他恶性样瘤的发生率较高，因此70岁以上暴露在阳光下的KA样病变应仔细评估，考虑其潜在的恶性风险。
Keratoacanthoma (KA) is a unique and distinct clinicopathological entity, although there is often confusion regarding its differentiation from other types of crateriform tumors. In this study, the clinicopathological features of 380 epidermal crateriform tumors with a central keratin plug were re-examined and the tumors were histologically classified into seven types: (i) crateriform verruca; (ii) crateriform seborrheic keratosis; (iii) KA; (iv) KA with a conventional squamous cell carcinoma (SCC) component (KA-like SCC and KA with malignant transformation); (v) crateriform Bowen's disease; (vi) crateriform SCC arising from solar keratosis; and (vii) crater form of infundibular SCC. Our study proved that incidence of SCC developing in KA lesions was 17.4%. The incidence rate differed depending on a patient's ages: 8.3% in patients less than 70 years of age and 24.3% in those aged 70 years and older. Nearly all of the malignant crateriform neoplasms (94.7%) occurred on sun-exposed areas. Lesions on the face included 138 KA (59.5%), 65 malignant crateriform neoplasms (28%) and 29 benign crateriform neoplasms (12.5%). We conclude that KA is not a variant of SCC, but a benign and frequently regressing proliferative lesion or borderline neoplasm, although there is the potential for SCC to arise within KA. Because the incidence of SCC developed in KA lesions and the incidence of other malignant crateriform neoplasms are higher in patients aged 70 years and older, KA-like lesions on sun-exposed areas over 70 should be assessed carefully in consideration of the potential risk of malignancy.