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目的探讨肛门乳头状汗腺瘤的临床特点、病理形态、免疫组化及预后。方法收集8例肛门乳头状汗腺瘤资料,分析其临床特点,观察病理形态及免疫组化表型,通过随访了解预后。结果患者均为女性,中位年龄43岁。肿物位于肛门齿状线附近,均行包块切除,随访1年无复发。肿块最大径0.5~1.5 cm不等,镜下瘤组织呈密集的不规则腺管状,部分腺管折叠形成迷路,部分向腔内形成乳头状结构,上皮均由内层分泌性柱状上皮细胞及外层肌上皮细胞构成。免疫组化:8例内层柱状上皮细胞ER、广谱CK和CK7(+),CK20、CEA和villin(-);外层肌上皮细胞CK和p63(+)。结论肛门乳头状汗腺瘤非常少见,诊断主要靠病理确诊,免疫组化标记协助诊断,局部肿物切除为首选。
Objective To investigate the clinical features, pathological morphology, immunohistochemistry and prognosis of anterior papillary sweat adenoma. Methods The data of 8 cases of anal papillary sweat adenoma were collected. The clinical features were analyzed. The pathological features and immunohistochemical phenotypes were observed. The prognosis was followed up. Results All patients were female, with a median age of 43 years. Mass was located near the anus dentate line, were removed mass, follow-up 1 year without recurrence. The maximum diameter of the tumor ranged from 0.5 to 1.5 cm. Microscopic tumor tissue was densely irregular glandular tube, part of the glandular duct folded to form a labyrinthine structure, and part of the tumor formed a papillary structure into the cavity. The epithelium was composed of the inner secretory columnar epithelial cells and the outer Layered myoepithelial cells. Immunohistochemistry: ER, broad-spectrum CK and CK7 (+), CK20, CEA and villin (-) in 8 cases of inner columnar epithelial cells; CK and p63 (+) in outer myoepithelial cells. Conclusions Anal papillary sweat adenoma is very rare. The diagnosis mainly depends on the pathology. The immunohistochemical markers are helpful to diagnose and the local tumor removal is the first choice.