Barnard College, New York, NY.
Dermatopathology Section, Department of Pathology and Laboratory Medicine, VA Boston Healthcare System, Boston, MA; and.
Am J Dermatopathol. 2020 Sep;42(9):697-699. doi: 10.1097/DAD.0000000000001626.
An 83-year-old man presented with a tumor of the neck, clinically consistent with an epidermal inclusion cyst. Excisional biopsy revealed a deeply infiltrating spindled cell tumor. Immunohistochemical markers for S100, SOX-10, Melan-A, HMB-45, and NK1/C3 were negative. Based on the presence of an area of lentigo maligna and the histologic pattern of the spindle cell component, a diagnosis of desmoplastic melanoma was made despite the absence of immunophenotypic evidence for melanocytic differentiation. To the best of our knowledge, the complete lack of both S100 and SOX-10 makes this tumor an unprecedented case. To avoid ruling out the diagnosis of desmoplastic melanoma prematurely, physicians should be made aware of this possible immunohistochemical profile.
一位 83 岁男性因颈部肿瘤就诊，临床表现符合表皮包涵囊肿。切除活检显示为深部浸润性梭形细胞肿瘤。免疫组化标记物 S100、SOX-10、Melan-A、HMB-45 和 NK1/C3 均为阴性。鉴于存在一处恶性雀斑样痣和梭形细胞成分的组织学模式，尽管缺乏黑色素细胞分化的免疫表型证据，仍诊断为硬化性黑色素瘤。据我们所知，这种肿瘤完全缺乏 S100 和 SOX-10，属于前所未有的病例。为避免过早排除硬化性黑色素瘤的诊断，应让医生了解这种可能的免疫组化表型。
