Faculty of Medicine, Memorial University, St. John's, Newfoundland and Labrador, Canada.
Department of Pathology and Laboratory Medicine, Saskatchewan Health Authority, Saskatoon, Saskatchewan, Canada.
J Cutan Pathol. 2022 Apr;49(4):399-402. doi: 10.1111/cup.14172. Epub 2021 Dec 2.
An 80-year-old female presented with a slowly growing 2-cm nodule on her shoulder over a 1-year period. Histopathologic sections of a biopsy specimen showed a multinodular, dermal-based basaloid tumor with areas of clear-cell change, stromal induction, as well as significant cytologic atypia and atypical mitotic activity. An initial investigation revealed positive staining of CDX2, a well-known marker of tumors of gastrointestinal origin. The case was referred to our dermatopathology service for consultation to determine if the lesion was in keeping with a cutaneous metastasis. On receipt of the case, an extended immunohistochemical panel was performed including SATB2, which displayed a similar pattern of staining as seen with CDX2. Although pathologists are most familiar with CDX2 and SATB2 as markers of gastrointestinal origin, the recent dermatopathology literature highlights that primary adnexal lesions of the skin also display positivity for CDX2 and can exhibit SATB2 positivity. We share a case of pilomatrix carcinoma with positive expression of nuclear CDX2 and SATB2, adding to the recent literature to (a) increase recognition of this staining pattern in hair follicle tumors, and (b) discuss briefly the shared molecular underpinnings in the tumorigenesis of gastrointestinal tumors and tumors of hair follicle origin that help clarify this underrecognized immunohistochemical pattern.
一位 80 岁女性，1 年来肩部逐渐出现一个 2cm 的结节。活检标本的组织病理切片显示一个多结节性、真皮基底样的肿瘤，具有透明细胞改变、基质诱导以及明显的细胞学异型性和非典型有丝分裂活性。初步检查显示 CDX2 阳性，CDX2 是胃肠道来源肿瘤的一个众所周知的标志物。该病例被转介到我们的皮肤科病理服务处进行咨询，以确定病变是否符合皮肤转移。收到该病例后，进行了扩展的免疫组织化学检测，包括 SATB2，其染色模式与 CDX2 相似。尽管病理学家最熟悉 CDX2 和 SATB2 作为胃肠道来源的标志物，但最近的皮肤病理文献强调，皮肤的原发性附属器肿瘤也显示 CDX2 阳性，并且可以表现出 SATB2 阳性。我们分享了一个核 CDX2 和 SATB2 阳性表达的毛母细胞瘤病例，增加了对这种染色模式在毛囊肿瘤中的认识，并简要讨论了胃肠道肿瘤和毛囊来源肿瘤的肿瘤发生中的共同分子基础，有助于阐明这种认识不足的免疫组织化学模式。
