Akasaka T, Kon S
Department of Dermatology, Iwate Medical University, School of Medicine, Morioka, Japan.
J Dermatol. 1997 May;24(5):322-7. doi: 10.1111/j.1346-8138.1997.tb02798.x.
The present study reports two cases of basal cell carcinoma arising in seborrheic keratosis. The first case is a seventy-three-year-old female who presented with a blackish nodule arising from a pigmented lesion on her chest. Histopathological analysis of the nodule and the pigmented lesion revealed a basal cell carcinoma with hair follicular differentiation and an acanthotic seborrheic keratosis, respectively. The second case is a seventy-year-old female with a blackish nodule arising from a pigmented lesion on her back. Histological analysis of the nodule revealed an atypical basaloid cell mass surrounded by a seborrheic keratosis lesion. In addition to the coexisting seborrheic keratosis with the basal cell carcinoma, a basaloid follicular hamartoma that showed multiple hamartomatous hair follicles or small cysts replaced by a branching cord or lace-like network of basaloid cells surrounded by fibrovascular stroma was identified. We concluded that both cases presented a rare combination of a seborrheic keratosis which underwent a malignant change to basal cell carcinoma. It appears that both basal cell carcinomas and seborrheic keratosis may derive from a similar source: pluripotential cells of either the epidermis or hair follicle epithelium.
本研究报告了两例发生于脂溢性角化病的基底细胞癌病例。第一例是一名73岁女性，其胸部一个色素沉着病变处出现了一个黑色结节。对该结节和色素沉着病变进行组织病理学分析，结果分别显示为具有毛囊分化特征的基底细胞癌和棘层肥厚性脂溢性角化病。第二例是一名70岁女性，其背部一个色素沉着病变处出现了一个黑色结节。对该结节进行组织学分析，发现一个由脂溢性角化病病变包绕的非典型基底样细胞团块。除了基底细胞癌与脂溢性角化病并存外，还发现了一种基底样毛囊错构瘤，其表现为多个错构瘤性毛囊或小囊肿，被由纤维血管间质包绕的基底样细胞分支索或花边状网络所取代。我们得出结论，这两例均呈现出脂溢性角化病发生恶性转变为基底细胞癌这一罕见组合。看来基底细胞癌和脂溢性角化病可能都源自相似的来源：表皮或毛囊上皮的多能细胞。
