Shelekhova Ksenya V, Calonje Eduardo, Grossmann Petr, Kacerovska Denisa, Koudela Karel, Mirka Hynek, Michal Michal, Kazakov Dmitry V
*Department of Pathology, Clinical Oncological Scientific and Practical Centre for Specialized Medical Care, Saint-Petersburg, Russia; †St John's Institute of Dermatology, St Thomas Hospital, London, United Kingdom; ‡Bioptical Laboratory, Pilsen, Czech Republic; §Department of Pathology, Faculty of Medicine in Pilsen, Charles University in Prague, Pilsen, Czech Republic; ¶Department of Orthopedic and Traumatology; and ‖Department of Radiology, Charles University, Medical Faculty Hospital, Pilsen, Czech Republic.
Am J Dermatopathol. 2014 Oct;36(10):847-52. doi: 10.1097/DAD.0b013e318287d49f.
: The authors present 2 cases of a subcutaneous biphasic synovial sarcoma with marked apocrine differentiation that potentially may be confused with cutaneous epithelial neoplasms, including malignant apocrine mixed tumor or metaplastic carcinoma with an apocrine glandular component. Microscopically, both neoplasms had a biphasic architecture with the epithelial and spindle cell components. The epithelial component was prominent and consisted of simple glands with round lumina and complex glandular structures with intraluminal bridges forming cribriform areas. The glands were lined by cuboidal to columnar cells with eosinophilic or clear cytoplasm manifesting apical apocrine-like and intraluminal eosinophilic secretions. The spindle cell component was less prominent and was composed of relatively uniform or slightly atypical spindle sells surrounding and merging focally with the glandular structures. Immunohistochemically, the tumor cells in both components were positive for vimentin, AE1/AE3, CK7, and epithelial membrane antigen. Desmin, smooth muscle actin, muscle-specific actin, CD34, and S-100 protein were all negative. SYT-SSX1 gene fusion using fluorescence in situ hybridization and RT-PCR methods was detected in both cases.
作者报告了2例具有显著大汗腺分化的皮下双相性滑膜肉瘤病例，这类肿瘤可能会与皮肤上皮性肿瘤混淆，包括恶性大汗腺混合瘤或具有大汗腺成分的化生癌。显微镜下，这两种肿瘤均具有双相结构，由上皮成分和梭形细胞成分组成。上皮成分突出，由具有圆形管腔的简单腺体和形成筛状区域的腔内桥的复杂腺结构组成。腺体由立方状至柱状细胞衬里，细胞质嗜酸性或透明，表现为顶端大汗腺样和腔内嗜酸性分泌物。梭形细胞成分不那么突出，由相对均匀或稍不典型的梭形细胞组成，围绕腺体结构并与之局灶性融合。免疫组化显示，两种成分中的肿瘤细胞波形蛋白、AE1/AE3、CK7和上皮膜抗原均呈阳性。结蛋白、平滑肌肌动蛋白、肌肉特异性肌动蛋白、CD�、CD34和S-100蛋白均为阴性。两例均通过荧光原位杂交和逆转录聚合酶链反应方法检测到SYT-SSX1基因融合。
