Cooper P H, Mills S E, Leonard D D, Santa Cruz D J, Headington J T, Barr R J, Katz D A
Am J Surg Pathol. 1985 Jun;9(6):422-33. doi: 10.1097/00000478-198506000-00004.
This report describes 20 sclerosing adnexal carcinomas of the skin that recapitulate the sweat duct and share certain microscopic features with benign syringoma. Clinically, the neoplasms were slow-growing, indurated nodules or plaques. Sixteen were located on the face, including five on the upper lip. Three were situated in the axilla, and one involved the buttock. Twelve of the tumors (group 1) were composed primarily of cords and nests of whorled squamous cells with clear cell change and variable keratinization. Lumens consistent with ductal differentiation were few and isolated in some of these lesions, but others had more numerous and complex ducts. The remaining eight neoplasms (group 2) contained large numbers of small, uniform ducts, and exhibited little keratinization. Each neoplasm in the series infiltrated subcutaneous tissue or deeper tissues and was accompanied by sclerotic, fibrous stroma. Sixteen of the lesions (80%) exhibited perineural growth. One tumor involved an underlying lymph node, probably by direct extension. Cytologic atypicality was mild or lacking, and mitotic figures were sparse. Seven of 15 tumors (47%) with follow-up recurred, in some instances many years after primary excision. Tumor-free margins in the initial excision specimen appeared to be a favorable prognostic factor. The most aggressive lesion in the series showed increased cytologic atypicality in recurrences.
本报告描述了20例皮肤硬化性附属器癌，这些肿瘤重现了汗腺导管的特征，并与良性汗管瘤具有某些微观特征。临床上，这些肿瘤生长缓慢，表现为硬结性结节或斑块。16例位于面部，其中5例在上唇。3例位于腋窝，1例累及臀部。12例肿瘤（第1组）主要由呈漩涡状的鳞状细胞索和巢组成，伴有透明细胞改变和不同程度的角化。在其中一些病变中，与导管分化一致的管腔较少且孤立，但其他病变的导管则更多且更复杂。其余8例肿瘤（第2组）含有大量小而均匀的导管，角化程度较低。该系列中的每个肿瘤均浸润皮下组织或更深层组织，并伴有硬化性纤维间质。16例病变（80%）表现为神经周围生长。1例肿瘤可能通过直接蔓延累及深部淋巴结。细胞学异型性轻微或无，核分裂象稀少。15例有随访的肿瘤中，7例（47%）复发，有些复发发生在初次切除多年后。初次切除标本中切缘无肿瘤似乎是一个有利的预后因素。该系列中最具侵袭性的病变在复发时表现出细胞学异型性增加。
