病理
神经内分泌分化
梅克尔细胞癌
细胞角蛋白
默克尔细胞
鉴别诊断
突触素
癌
医学
免疫组织化学
癌症
内科学
前列腺癌
作者
Kaitlin Vanderbeck,Woo Cheal Cho,Phyu P. Aung,Doina Ivan,Aimi T Rothrock,Carlos A. Torres‐Cabala,Víctor G. Prieto,Jonathan L Curry,Priyadharsini Nagarajan
摘要
Merkel cell carcinoma (MCC) is an aggressive cutaneous neuroendocrine carcinoma that may occasionally present divergent histopathologic features. We present two cases of MCC demonstrating ductal differentiation, one on the lower lip of an 81-year-old man and another on the right forearm of a 67-year-old man. The histopathologic features included TTF1-negative, infiltrative, high-grade basaloid tumor with paranuclear punctate positivity for cytokeratin (CK) 20 and synaptophysin. Rare luminal structures lined by atypical epithelioid cells positive for CEA and CK19 were noted, confirming the presence of ductal differentiation. Although the ductal differentiation is unusual, other histopathologic features and the immunohistochemical profile supported the diagnosis of MCC. Like most divergent features, ductal differentiation is rare in MCC and typically constitutes a very small proportion of the tumor, and is therefore under-recognized. Although the clinical significance of this feature is unclear, recognition and documentation of ductal differentiation and distinguishing it from other mimics such as acantholysis within squamous nests and entrapped eccrine ducts is essential to determine its clinical significance. We also discuss the differential diagnoses of cutaneous basaloid neoplasms with ductal differentiation.
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