乳暈處具畸形細胞核之平滑肌瘤

Mammary Areolar Leiomyoma with Bizarre Nuclei

李淑芬(Shu-Fen Lee) ； 李玉雲(Yu-Yun Lee)

《中華皮膚科醫學雜誌》 20卷4期 (2002/12) Pp. 299-302

https://doi.org/10.29784/DS.200212.0006

摘要

皮膚平滑肌瘤是一種源自平滑肌纖維的良性腫瘤，偶爾可見多形性細胞核之變異型一具畸形細胞核之平滑肌瘤。肉膜狀平滑肌瘤(dartoic leiomyoma)乃源自於生殖器、乳暈及乳頭之肉膜肌。位於乳暈處之平滑肌瘤相當少見，在此我們報告一文獻上首例發生於乳暈之具畸形細胞核之平滑肌瘤(leiomyoma with bizarre nuclei)。病人為51歲男性，於其右側乳暈有一稍硬、棕色、往外突起之結節，已有兩年的時間；手術切除後經病理檢查於真皮層可見許多分化良好之平滑肌細胞，交織排列成纖維束，有些細胞核呈較大、多性變化；但是並無細胞數目增加及有絲分裂活動增加的現象，根據上述病理變化，我們診斷此為一具畸形細胞核之平滑肌瘤。此種細胞核呈多形性變化的現象若不伴隨細胞數目增加及有絲分裂活動增加，代表良性腫瘤已逐漸退化，而非腫瘤有惡性變化。此種現象可見於多種良性之梭狀細胞腫瘤(spindle cell tumors)，包括滑肌瘤。

並列摘要

Cutaneous leiomyomas are benign smooth muscle tumors. Pleomorphic nuclei are seen in its unusual variant, leiomyoma with bizarre nuclei. Dartoic leiomyomas are originated in the dartos mus- cles of the genitalia, mammary areola, and nipple. Leiomyomas of the mammary areola are rare. In this report, we describe a very rare example and the first case of mammary areolar leiomyoma with bizarre nuclei. The patient was a 51-year-old man who noted a firm, brownish, polypoid nodule on the areola of the right breast for a two-year duration. Total excision was done and the pathology revealed proliferation of well-differentiated smooth muscle cells arranged in interweaving fascicles in the dermis. A few cells had large pleomorphic muclei. However, there was no hypercellularity or mitotic figures. The findings were consistent with leiomyoma with bizarre nuclei. Nuclear pleomor-phism not in association with increased cellularity or mitotic figures is thought to represent degenera- tive change and should not be regarded as evidence of malignancy by itself. This phenomenon can be observed in several types of benign spindle cell tumors, including leiomyoma.

並列關鍵字

Leiomyoma ； Bizarre nuclei ； Mammary areola