Kato N, Aoyagi S, Sugawara H, Mayuzumi M
Department of Dermatology and Clinical Research Institute, National Sapporo Hospital, Kikusui 4-2, Shiroishi-ku, 003-0804 Sapporo, Japan.
Am J Dermatopathol. 2001 Jun;23(3):216-20. doi: 10.1097/00000372-200106000-00009.
The first case of primary cutaneous squamous cell carcinoma (SCC) to cause zosteriform and epidermotropic metastasis to skin is reported. The patient is a 72-year-old Japanese woman. A cutaneous SCC appeared on the lateral side of her right knee and was removed. After dissection of the right inguinal lymph nodes, which revealed metastases, and irradiation of the right inguinal region, the patient presented with slightly pruritic and painful erythematous papules on the right hip and small brownish papules and vesicles with crusts on the anterior side of the right thigh. The eruptions were in a zosteriform distribution along the right L1 to L3 dermatomes. Histologically neoplastic squamous cell nests were observed in the epidermis, below the epidermal-dermal junction, and within lymphatic vessels in the deeper reticular dermis. We postulate that neoplastic cells with the ability to fuse with adjacent squamous epithelium may have been carried beneath the basal lamina or to the epidermis via dermal lymphatic backflow, resulting in epidermotropic metastasis.
报告了首例引起带状疱疹样和向表皮性皮肤转移的原发性皮肤鳞状细胞癌（SCC）病例。患者为一名72岁的日本女性。其右膝外侧出现皮肤SCC并被切除。在对右腹股沟淋巴结进行解剖发现转移灶并对右腹股沟区进行放疗后，患者右髋部出现轻度瘙痒和疼痛的红斑丘疹，右大腿前侧出现小的褐色丘疹及结痂水疱。皮疹沿右侧L1至L3皮节呈带状疱疹样分布。组织学检查发现，在表皮、表皮-真皮交界处下方以及深部网状真皮的淋巴管内可见肿瘤性鳞状细胞巢。我们推测，具有与相邻鳞状上皮融合能力的肿瘤细胞可能通过真皮淋巴管逆流被带到基底层下方或表皮，从而导致向表皮性转移。
