Stern J B, Haupt H M
Dermatopathology Consultation Services, Damascus, Maryland 20872.
Am J Surg Pathol. 1990 Feb;14(2):183-5. doi: 10.1097/00000478-199002000-00010.
Perineural invasion has been reported to occur in both benign and malignant neoplasms. We describe two cases in which perineural invasion by epithelial cells was present in reexcision skin specimens removed because of melanocytic lesions in the original biopsy material. Because of the absence of a primary epithelial neoplasm, this phenomenon was interpreted as a reactive or reparative process, most probably resulting from regenerating traumatized sweat gland ducts. On the basis of this study alone, it may not be possible to distinguish between reexcision perineural invasion and perineural invasion from a primary epithelial neoplasm. For such cases, the following histologic features serve as provisional guidelines favoring an interpretation of reexcision perineural invasion: absence of perineural spread beyond the immediate previous biopsy site, benign appearance of the perineural epithelial cells different from the appearance of the original tumor, and absence of residual epithelial tumor in the vicinity of the involved perineurium.
据报道，神经周围侵犯可发生于良性和恶性肿瘤。我们描述了两例病例，在因原始活检材料中的黑素细胞病变而切除的再次切除皮肤标本中存在上皮细胞的神经周围侵犯。由于不存在原发性上皮肿瘤，这种现象被解释为一种反应性或修复性过程，很可能是由受创伤的汗腺导管再生所致。仅基于这项研究，可能无法区分再次切除时的神经周围侵犯和原发性上皮肿瘤的神经周围侵犯。对于此类病例，以下组织学特征可作为支持再次切除时神经周围侵犯这一解释的临时指导原则：神经周围扩散未超出紧邻的先前活检部位，神经周围上皮细胞的良性外观与原始肿瘤外观不同，以及在受累神经周围附近无残留上皮肿瘤。
