摘要
背景：合併廣泛之脂肪性變化的皮膚混合瘤是一種甚少見於文獻記載的疾病。大部分的作者認為其脂肪變化是由腫瘤細胞本身變形生長而來的或是脂肪樣變性。 目標：本研究的目標為探討合併脂肪性變化的皮膚混合瘤之發生率並藉由病理學及免疫組織化學試圖找尋其發生原因。 方式：我們從過去二十年的病例檔案裡選出經病理切片診斷為皮膚混合瘤的病例，重新檢視並針對合併大量脂肪性變化的病例進行病理檢驗及對S-100蛋白、膠質纖維酸性蛋白、平滑肌肌動蛋白的特殊染色。 結果：我們一共分析了29個皮膚混合瘤的病例並且發現13例(45%)合併脂肪性變化，而其中4例(14%)則含有廣泛之脂肪性變化。較成熟的類脂肪細胞對S-100染色極為顯著而對平滑肌肌動蛋白，膠質纖維酸性蛋白染色則不明顯。在上皮與類脂肪區域交界處有發現一些“中間”細胞。 結論：合併脂肪性變化的皮膚混合瘤似乎並沒有想像中的罕見。S-100蛋白於脂肪樣變化處的強烈表現，與“中間”細胞的發現使我們認為變形生長是比較能解釋其來源。
關鍵字
無資料並列摘要
Background: Mixed tumors of the skin showing extensive lipomatous change have been reported scantly in the literature. The cause of this change is under debate and have generally been attributed to metaplasia of the tumor cells or less commonly, lipomatous degeneration. Objective: This study was aimed to evaluate how often the lipomatous change happen in mixed tumors and attempt to elucidate the etiology of such changes via histopathological and immunohistiochemical methods. Methods: Cases diagnosed as cutaneous mixed tumors within the past twenty years were retrieved from our archives and reevaluated. Those with extensive lipomatous component were submitted to special staining: smooth muscle actin, glial fibrillary acidic protein, and S-100 protein Results: Twenty-nine cases were reviewed histopathologically. Varying degrees of lipomatous differentiation was noted in thirteen (45%) cases. In four (14%) of them, the lipomatous component constituted larger than 20% of the total stromal component. The lipomatous cells strongly expressed S-100 protein, but reacted negatively to smooth muscle actin or glial fibrillary acidic protein. Some intermediate cells were noted in intermediate zones. Conclusion: Lipomatous change in mixed tumors of the skin may be more common than previously thought. The strong expression of S-100 protein in the lipomatous cells and the finding of intermediate cells support the notion that metaplasia of myoepithelial cells plays a role in the stromal differentiation of mixed tumors.
延伸閱讀
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