Rodić Nemanja, Taube Janis M, Manson Paul, Patel Manisha, Patterson James W, Erdag Gulsun
Department of Pathology, Johns Hopkins Hospital, Baltimore, MD 21205, USA.
Am J Dermatopathol. 2013 Jun;35(4):e72-6. doi: 10.1097/DAD.0b013e31827d989c.
Dermal-based combined squamous and melanocytic neoplasms are emerging clinicopathologic entities that tend to appear on sun-exposed areas of elderly patients. The biologic behavior of such cutaneous neoplasms remains uncertain because of their rarity. Histopathologic differential includes the following diagnostic entities: (1) dermal squamomelanocytic tumor, (2) melanocytic matricoma, and (3) rare histologic variant of pilomatrical carcinoma, the so-called pilomatrical carcinoma with intralesional melanocytes. Herein, we present a novel case of locally invasive dermal squamomelanocytic tumor. A 72-year-old man presented with a pigmented papule on nasal ala that was clinically concerning for basal cell carcinoma. Histopathologic evaluation demonstrated atypical melanocytic cells architecturally and intimately intermixed with single units and clusters of atypical squamous cells. Most notable feature of this case is focal matrical differentiation and locally invasive tumor growth, characterized by multifocal perineural invasion.
基于皮肤的鳞状和黑素细胞混合性肿瘤是新出现的临床病理实体，多见于老年患者暴露于阳光下的部位。由于此类皮肤肿瘤罕见，其生物学行为尚不确定。组织病理学鉴别诊断包括以下诊断实体：（1）皮肤鳞状黑素细胞瘤，（2）黑素细胞毛母质瘤，（3）毛母质癌的罕见组织学变异型，即所谓的伴有瘤内黑素细胞的毛母质癌。在此，我们报告一例局部侵袭性皮肤鳞状黑素细胞瘤的新病例。一名72岁男性患者鼻翼出现一个色素性丘疹，临床怀疑为基底细胞癌。组织病理学评估显示非典型黑素细胞在结构上与单个单位及非典型鳞状细胞簇紧密混合。该病例最显著的特征是局灶性毛母质分化和局部侵袭性肿瘤生长，表现为多灶性神经周围侵犯。
