Piñol Aguadé J, Pedragosa Jové R, Tomás J M, Torres A
Med Cutan Ibero Lat Am. 1976;4(1):23-40.
After a review of the bibliography on the subject of eccrine sweat gland carcinomas, the authors emphasize the confusing terminology used for the designation of these cases and the difficulties for a correct clinical and histological diagnosis of these tumors. According to the data obtained from the study of 7 personal cases, the most characteristic features of the eccrine carcinomas could be the following: 1) From the clinical standpoint--Appearance of a single tumour, lasting unmodified for a long period of time.--Tendency to reccurrence of the neighbouring areas after tumour excision, and to a slow progression through the superficial lymphatic channels.--Appearance of distant metastasis a long time after the original lesion. These metastases are observed, a) on the regional lymph nodes, b) on the superficial lymphatic channels and c) in some cases in the skin by intraepidermal growth. 2) From the histological point of view--Localisation in the deep dermis of the tumoral masses in the original lesion.--Acinar or tubular structures. Abundant nitoses and considerable indifferntiation of the cellular elements.--Tendency to the formation of empty peritumoral spaces separating the tumoral masses from the connective tissue by the retraction caused by the fixative.--Styloid or trabecular growth surrounding the main mass of the tumor.--Two types of cells can be observed in some tumours; large cells with a clear cytoplasm and small deeply-stained cells resembling the mioepithelial cells.--Tendency to the formation of clear cell tumoral masses.--Squamous metaplasia of isolated cells or groups of cells.--Presence of PAS-positive cytoplasmatic granulations in some cellular elements.--Degenerative changes with secondary cystic formations.--Frequent features of tumoral lymphangitis. 3y From theions.--Frequent features of tumoral lymphangitis. 3) From the cytological standpoint Staining in yellow of the cytoplasms of the tumour cells with the Panpanicolau method. 4) From the ultrastructural standpoint--Impossibility of classifiying the cells into serous or mucous due to the considerable anaplasia.--Absence of eccrine-apocrine differentiation, of ductal formation and of embrionary sweat cell features.
在回顾了有关小汗腺癌主题的文献后，作者强调了用于命名这些病例的术语令人困惑，以及对这些肿瘤进行正确临床和组织学诊断存在困难。根据对7例个人病例研究获得的数据，小汗腺癌最具特征性的表现可能如下：1）从临床角度来看——单个肿瘤出现，长时间保持不变。——肿瘤切除后邻近区域有复发倾向，并通过浅表淋巴管缓慢进展。——在原发病变很长时间后出现远处转移。这些转移见于：a）区域淋巴结，b）浅表淋巴管，c）在某些情况下通过表皮内生长见于皮肤。2）从组织学角度来看——肿瘤团块位于原发病变的真皮深层。——腺泡状或管状结构。细胞成分有大量核仁且分化程度相当低。——由于固定剂引起的收缩，有形成将肿瘤团块与结缔组织分隔开的瘤周间隙的倾向。——围绕肿瘤主体的柱状或小梁状生长。在一些肿瘤中可观察到两种细胞；胞质清晰的大细胞和类似肌上皮细胞的深染小细胞。——有形成透明细胞肿瘤团块的倾向。——单个细胞或细胞群的鳞状化生。——一些细胞成分中存在PAS阳性胞质颗粒。——伴有继发性囊性形成的退行性改变。——肿瘤性淋巴管炎常见。3）从细胞学角度来看——用潘帕尼科拉乌方法染色时肿瘤细胞胞质呈黄色。4）从超微结构角度来看——由于细胞的高度间变，无法将细胞分类为浆液性或黏液性。——不存在小汗腺 - 大汗腺分化、导管形成和胚胎性汗腺细胞特征。
