Massey R A, Tok J, Strippoli B A, Szabolcs M J, Silvers D N, Eliezri Y D
Department of Dermatology, Columbia University-College of Physicians and Surgeons, New York, New York, USA.
Dermatol Surg. 1998 Sep;24(9):995-8. doi: 10.1111/j.1524-4725.1998.tb04293.x.
Dermatofibrosarcoma protuberans (DFSP) is a tumor with a high local reoccurrence rate. Mohs micrographic surgery offers the highest cure rate. However, differentiating minimal residual tumor from normal skin can be difficult during Mohs surgery.
To clarify the problem of determining when a tumor-free plane had been achieved during Mohs surgery for a DFSP.
In two patients with DFSPs, we compared frozen and paraffin-embedded sections extending from tumor to normal skin, using both H&E and CD34 stains.
On frozen, but not paraffin-embedded, sections scattered dermal spindle cells were seen in normal skin.
Scattered dermal spindle cells in the dermis of normal skin make it difficult to differentiate minimal residual tumor from normal dermis during Mohs surgery. A biopsy of normal skin can be useful as a control in this setting.
隆突性皮肤纤维肉瘤(DFSP)是一种局部复发率高的肿瘤。莫氏显微外科手术的治愈率最高。然而,在莫氏手术过程中,区分微小残留肿瘤与正常皮肤可能具有挑战性。
阐明在DFSP的莫氏手术中确定何时达到无瘤平面的问题。
在两名DFSP患者中,我们使用苏木精-伊红(H&E)染色和CD34染色,比较了从肿瘤延伸至正常皮肤的冰冻切片和石蜡包埋切片。
在冰冻切片而非石蜡包埋切片上,正常皮肤中可见散在的真皮梭形细胞。
正常皮肤真皮中散在的真皮梭形细胞使得在莫氏手术中区分微小残留肿瘤与正常真皮变得困难。在这种情况下,正常皮肤活检作为对照可能有用。