Hartman Rebecca I, Chu Emily Y, Acker Scott M, James William D, Elenitsas Rosalie, Kovarik Carrie L
Department of Dermatology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Am J Dermatopathol. 2013 Jul;35(5):601-5. doi: 10.1097/DAD.0b013e31827e2fc1.
There are multiple clinical and histopathologic presentations of cutaneous metastases. We report 3 cases of visceral malignancies metastasizing to the skin and histopathologically mimicking interstitial granulomatous processes, including granuloma annulare and interstitial granulomatous dermatitis. Histopathologic examination of skin biopsy specimens, from our patients with established histories of cancer, revealed malignant carcinoma-derived cells organized in an interstitial pattern. Of note, some of the lesional cells appeared relatively bland without significant cellular atypia. When examining a skin biopsy of a new lesion from a patient with a history of internal malignancy, it is important to perform immunohistochemical staining to evaluate for metastatic disease, even if the histological pattern is suggestive of a benign interstitial granulomatous process.
皮肤转移瘤有多种临床和组织病理学表现。我们报告3例内脏恶性肿瘤转移至皮肤且组织病理学上酷似间质性肉芽肿性病变的病例,包括环状肉芽肿和间质性肉芽肿性皮炎。对有明确癌症病史患者的皮肤活检标本进行组织病理学检查,发现恶性癌细胞呈间质性排列。值得注意的是,一些病变细胞看起来相对温和,无明显细胞异型性。当检查有内脏恶性肿瘤病史患者新出现病变的皮肤活检时,即使组织学模式提示为良性间质性肉芽肿性病变,进行免疫组化染色以评估是否为转移性疾病也很重要。