Flux Katharina, Brenn Thomas
Labor für Dermatohistologie und Oralpathologie, Bayerstrasse 69, Munich 80335, Germany; Department of Dermatology, University of Heidelberg, Neuenheimer Feld 440, Heidelberg 69120, Germany.
Department of Pathology, Western General Hospital, The University of Edinburgh, Crewe Road, Edinburgh EH4 2XU, UK.
Clin Lab Med. 2017 Sep;37(3):587-601. doi: 10.1016/j.cll.2017.05.006. Epub 2017 Jun 9.
This article focuses on primary cutaneous sweat gland carcinomas with basaloid differentiation, including cribriform apocrine carcinoma, endocrine mucin-producing sweat gland carcinoma, mucinous carcinoma, adenoid cystic carcinoma, spiradenocarcinoma, and digital papillary adenocarcinoma. These tumors are rare and pose a significant diagnostic challenge. Their clinical presentation is nonspecific and there is significant overlap of their histologic features. Confident diagnosis is necessary because their clinical behavior ranges from indolent, nonrecurring, nonmetastasizing tumors to those with potential for disseminated disease and mortality. They should be separated from cutaneous metastases of primary visceral adenocarcinomas. Salient features of these rare entities are discussed with emphasis on distinguishing features and diagnostic clues.
本文聚焦于具有基底样分化的原发性皮肤汗腺癌,包括筛状大汗腺癌、内分泌黏液生成汗腺癌、黏液癌、腺样囊性癌、螺旋腺癌和指状乳头状腺癌。这些肿瘤较为罕见,诊断面临重大挑战。它们的临床表现缺乏特异性,组织学特征也有显著重叠。明确诊断很有必要,因为其临床行为差异很大,从惰性、不复发、不转移的肿瘤到具有播散性疾病和致死风险的肿瘤都有。应将它们与原发性内脏腺癌的皮肤转移瘤区分开来。本文讨论了这些罕见实体的显著特征,重点强调鉴别特征和诊断线索。