Le Mary D, Hassan Khaled, Cassarino David S
*Department of Pathology, Harbor-UCLA Medical Center, Torrance, CA; †St. Jude Medical Center, Fullerton, CA; and ‡Department of Pathology, Southern California Permanente Medical Group, Sunset Medical Center, Los Angeles, CA.
Am J Dermatopathol. 2016 Jan;38(1):73-6. doi: 10.1097/DAD.0000000000000351.
Sarcomatoid carcinomas are rare malignant tumors, which usually demonstrate a well-differentiated epithelial component in association with a poorly differentiated spindle-cell component. Several different subtypes have been reported and categorized primarily under the differentiated epithelial component, with the majority of cutaneous sarcomatoid carcinomas arising in the setting of a basal cell or squamous cell carcinoma. To date, only 4 cases of sarcomatoid porocarcinoma have been reported in the literature. The authors present a case of an 84-year-old woman with an ulcerated papule on her scalp for several months. Histopathology revealed an exophytic and endophytic epidermal proliferation with multiple mitoses and ductal differentiation overlying a poorly differentiated, infiltrative spindle-cell proliferation in the dermis. Ductal and cystic structures were scattered throughout the malignancy. Immunohistochemistry was notable for strong and diffuse pancytokeratin positivity, p63 positivity, focally positive carcinoembryonic antigen within the ductal lumina, and periodic acid-schiff-positive, diastase-resistant intracellular deposits. They present the findings of this rare case of primary cutaneous sarcomatoid porocarcinoma.
肉瘤样癌是罕见的恶性肿瘤，通常表现为一个分化良好的上皮成分与一个分化差的梭形细胞成分相关联。已经报道了几种不同的亚型，主要根据分化的上皮成分进行分类，大多数皮肤肉瘤样癌发生在基底细胞癌或鳞状细胞癌的背景下。迄今为止，文献中仅报道了4例肉瘤样汗孔癌。作者报告了一例84岁女性，头皮上有一个溃疡丘疹数月。组织病理学显示外生性和内生性表皮增生，有多个核分裂和导管分化，其下方是真皮中分化差的浸润性梭形细胞增生。导管和囊性结构散布于整个恶性肿瘤中。免疫组化显示弥漫性强阳性全细胞角蛋白、p63阳性、导管腔内灶性癌胚抗原阳性，以及高碘酸-希夫染色阳性、淀粉酶抵抗性细胞内沉积物。他们展示了这例原发性皮肤肉瘤样汗孔癌罕见病例的研究结果。
