Bottoni U, Dianzani C, Pranteda G, Innocenzi D, De Giacomo P, Balzani A, Zampetti M, Pala S, Calvieri S
Istituto di Dermatologia, Università di Roma La Sapienza, Italy.
J Eur Acad Dermatol Venereol. 2000 May;14(3):205-8. doi: 10.1046/j.1468-3083.2000.00051.x.
This is the report of an 80-year-old patient with diffuse brownish hyperpigmentation and velvety thickening of the skin with onset 1 year before. Warty lesions on his limbs were present as well as papillomatous and verrucous lesions on his lips, mouth and eyelid conjunctivae with hyperkeratosis of the nipples. Biopsies, performed at different sites, showed histological pictures consistent with a diagnosis of acanthosis nigricans (AN) with florid cutaneous and mucosal papillomatosis. This type of AN is frequently associated with internal malignancy. In our patient serum levels of tissue polypeptide antigen, carcinoembryonic antigen, cytokeratin fragment and squamous cell carcinoma antigen were high and chest computed tomography scan indicated a large tumour infiltrating the right lung and extending to the mediastinum. Cytological examination of bronchial drainage revealed the presence of neoplastic cells, non-small cell type carcinoma. The most frequent cancer associated with malignant AN is gastric adenocarcinoma. Lung tumour has rarely been reported with AN. Malignant AN is sometimes associated with other cutaneous and mucosal warty lesions, as in our patient. These various skin and mucosal lesions are the expression of a systemic epithelial disorder and may help clinicians to suspect a malignant form of AN.
这是一份关于一名80岁患者的报告，该患者有弥漫性褐色色素沉着和皮肤天鹅绒样增厚，起病于1年前。其四肢有疣状病变，嘴唇、口腔和眼睑结膜有乳头状和疣状病变，乳头有角化过度。在不同部位进行的活检显示组织学图像符合伴有明显皮肤和黏膜乳头状瘤病的黑棘皮病（AN）诊断。这种类型的AN常与内脏恶性肿瘤相关。在我们的患者中，组织多肽抗原、癌胚抗原、细胞角蛋白片段和鳞状细胞癌抗原的血清水平较高，胸部计算机断层扫描显示一个大肿瘤浸润右肺并延伸至纵隔。支气管引流液的细胞学检查发现了肿瘤细胞，为非小细胞型癌。与恶性AN相关最常见的癌症是胃腺癌。与AN相关的肺肿瘤很少见。恶性AN有时与其他皮肤和黏膜疣状病变相关，就像我们的患者一样。这些各种皮肤和黏膜病变是一种系统性上皮紊乱的表现，可能有助于临床医生怀疑恶性形式的AN。
