Large-cell neuroendocrine carcinoma of the skin: ultrastructural and immunohistochemical findings
Large-cell neuroendocrine carcinoma of the skin: ultrastructural and immunohistochemical findings
复制标题
皮肤大细胞神经内分泌癌：超微结构和免疫组织化学发现
DOI：
10.1111/cup.12794
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发表时间：
2016
影响因子：
1.7
通讯作者：
and Yutaka Narisawa
中科院分区：
文献类型：
--
作者：
Kotaro Nagase;Hiromi Kimura;Naomi Yonekura;Shinichi Koba;Takuya Inoue;and Yutaka Narisawa
大细胞神经内分泌癌（LCNEC）是一种罕见的侵袭性神经内分泌肿瘤，主要见于肺部。尽管LCNEC已在各种器官中报道，但皮肤的LCNEC极其罕见，认识不足，甚至可能被低估。在此我们报告一例皮肤LCNEC，着重于详细的组织病理学和超微结构的结果。患者是一名85岁的日本女性，右上眼睑有肿块。活检标本显示一个浸润性肿块延伸到皮下组织。肿瘤细胞呈片状、巢状和小梁索状排列。观察到广泛的坏死区域。大多数肿瘤细胞具有细胞大、多边形、核质比低、核染色质粗和核仁多的特征。CD56、NSE、AE1/AE3、CK7阳性，CK20、TTF-1、突触素和嗜铬粒蛋白A阴性。系统的影像学检查显示，除了右上眼睑肿块外，没有其他肿瘤性病变。这些结果表明，目前的情况下，是一个LCNEC的皮肤。皮肤中LCNEC的存在应该被认识到，因为它是一种罕见的癌症变体，可能被误解为转移或默克尔细胞癌。
Large‐cell neuroendocrine carcinoma (LCNEC) is an uncommon and aggressive neuroendocrine tumor, found mainly in the lung. Although LCNEC has been reported in various organs, LCNEC of the skin is extremely rare, poorly recognized and probably underestimated. Here we report a case of LCNEC of the skin, focusing on the histopathological and ultrastructural findings in detail. The patient was an 85‐year‐old Japanese woman presented with a mass on her right upper eyelid. Biopsy specimen showed an infiltrative mass with extension into the subcutis. Tumor cells were arranged in organoid and trabecular patterns with sheets, nests and trabecular cords. Extensive necrotic areas were observed. Most of the tumor cells were characterized by large cell size, polygonal shape, low nuclear‐cytoplasmic ratio, coarse nuclear chromatin and frequent nucleoli. They were positive for CD56, NSE, AE1/AE3, CK7, and negative for CK20, TTF‐1, synaptophysin and chromogranin A. A systematic radiographic examination revealed no additional neoplastic lesions other than the right upper eyelid mass. These findings suggest that the present case is a LCNEC of the skin. The existence of LCNEC in the skin should be recognized, as it is a rare variant of carcinoma that can potentially be misconstrued as a metastasis or as Merkel cell carcinoma.