Zhang Ling, Li Li, Wang Yun, Wang Xiao Ling
Department of Pathology, Guang'an Men Hospital, China Academy of Chinese Medical Sciences, Beijing, PR China.
Histol Histopathol. 2025 Jun;40(6):911-917. doi: 10.14670/HH-18-828. Epub 2024 Oct 4.
To explore the clinicopathological and morphological characteristics, diagnosis, differential diagnosis, treatment, and prognosis of primary signet-ring cell/histiocytoid carcinoma (SRCHC) of the axilla.
The clinical manifestations, pathomorphological characteristics, and immunohistochemical staining results of a case of primary SRCHC in the axilla were retrospectively analyzed, and the relevant literature was reviewed.
The patient was a 69-year-old male. Subcutaneous gray-white nodules with unclear boundaries were visible. Microscopic examination: The tumor was located in the dermis and subcutaneous tissue. The tumor cells were arranged in a cord-like, soldier-like, or nest-like shape, with mild to moderate atypia. Some cells had obvious nucleoli. The tumor cytoplasm was eosinophilic, and mucoid material inside and outside the cells could be seen, showing a signet-ring-like or histiocytoid appearance. Immunohistochemical staining was positive for GCDFP-15, CK7, E-cadherin, AR, P120, GATA3 and negative for Villin, S-100, CK20, SMA, P63, CD68, TTF-1, NapsinA, ER, PR, and Ki-67 proliferation index (8%), HER2(2+) and FISH(-). The special staining AB-PAS (AB+,PAS-).
Cutaneous axillary primary SRCHC is extremely rare and highly invasive and needs to be differentiated from a variety of metastatic tumors (breast, digestive system, lung, etc.).
探讨腋窝原发性印戒细胞/组织细胞样癌（SRCHC）的临床病理及形态学特征、诊断、鉴别诊断、治疗及预后。
回顾性分析1例腋窝原发性SRCHC的临床表现、病理形态学特征及免疫组化染色结果，并复习相关文献。
患者为69岁男性。可见边界不清的皮下灰白色结节。显微镜检查：肿瘤位于真皮和皮下组织。肿瘤细胞呈条索状、巢状或团块状排列，有轻至中度异型性。部分细胞有明显核仁。肿瘤细胞质呈嗜酸性，可见细胞内外黏液样物质，呈印戒样或组织细胞样外观。免疫组化染色GCDFP-15、CK7、E-cadherin、AR、P120、GATA3阳性，Villin、S-100、CK20、SMA、P63、CD68、TTF-1、NapsinA、ER、PR及Ki-67增殖指数（8%）、HER2（2+）及FISH（-）阴性。特殊染色AB-PAS（AB+，PAS-）。
腋窝皮肤原发性SRCHC极为罕见，侵袭性强，需与多种转移性肿瘤（乳腺、消化系统、肺等）相鉴别。
