Bates A W, Baithun S I
Department of Morbid Anatomy, St. Bartholomew's and the Royal London School of Medicine and Dentistry, The Royal London Hospital, UK.
Am J Dermatopathol. 1998 Feb;20(1):35-40. doi: 10.1097/00000372-199802000-00007.
Three cases of cutaneous mixed tumor with atypical features are described. These biphasic tumors comprise cords and nests of often plasmacytoid cells with areas of tubule formation, set in a chondroid stroma. The tumor cells show immunohistochemical positivity for both CAM 5.2 and S-100 and ultrastructural features of myoepithelium. The atypical histological features of an infiltrative margin, satellite tumor nodules, and tumor necrosis, which were present in these cases, have been described in malignant chondroid syringoma; however, a review of the small number of previous case reports demonstrates that histological appearances did not always correspond with apparent malignant potential in this tumor. The term atypical mixed tumor is recommended for tumors in which there are histological features of malignancy, especially local invasion, without proven metastases. Complete excision of the tumor and careful follow-up are advised, as at present the malignant potential of these tumors cannot be reliably predicted from their histological appearance.
本文描述了3例具有非典型特征的皮肤混合瘤。这些双相性肿瘤由通常呈浆细胞样的细胞条索和巢团构成，并伴有小管形成区域，位于软骨样基质中。肿瘤细胞对CAM 5.2和S-100均呈免疫组化阳性，并具有肌上皮的超微结构特征。这些病例中出现的浸润性边缘、卫星瘤结节和肿瘤坏死等非典型组织学特征，在恶性软骨样汗腺瘤中已有描述；然而，回顾此前少量的病例报告表明，该肿瘤的组织学表现并不总是与明显的恶性潜能相对应。对于具有恶性组织学特征，尤其是局部侵袭但无远处转移证据的肿瘤，建议使用非典型混合瘤这一术语。建议完整切除肿瘤并进行仔细随访，因为目前无法根据这些肿瘤的组织学表现可靠地预测其恶性潜能。
