背景:许多皮肤病变在临床上被怀疑为“囊肿”;然而,组织病理学检查后,被发现是更显著的病变。这里,我们研究了恶性肿瘤与皮肤囊肿的临床差异的频率和特征。
方法:对JamesA.HaleyVeterans医院2018年1月至2022年12月的手术病理标本进行回顾性研究。包含临床诊断为“囊肿”的皮肤标本。总结其临床病理特征。
结果:癌前或恶性肿瘤占临床上所有囊肿标本的4.5%。大多数模仿囊肿的癌症是基底细胞癌(BCC)或鳞状细胞癌(SCC);然而,预后较差的癌症,比如默克尔细胞癌和黑色素瘤,临床上也伪装成囊肿。BCC主要是结节状的,SCCs在很大程度上具有良好的分化和侵入性。许多表现出与良性囊肿相符的临床体征和症状,如中央泪点,疼痛,和快速增长。确定的危险因素包括既往非黑色素瘤皮肤癌诊断史,先前的切除,和免疫抑制。
结论:许多临床上与皮肤囊肿有关的病变在组织病理学检查后被发现是恶性肿瘤。因此,活检后,所有囊肿样病变都应进行显微镜检查,特别是在皮肤癌发病率增加的某些临床环境中。
BACKGROUND: Many cutaneous lesions are clinically suspected as \"
cyst\"; however, following histopathological examination, are found to be more significant lesions. Here, we examine the frequency and features of malignancies with cutaneous cysts in the clinical differential.
METHODS: A retrospective study of surgical pathology specimens at the James A. Haley Veterans\' Hospital from January 2018 to December 2022 was conducted. Cutaneous specimens containing the clinical diagnosis of \"
cyst\" were included. The clinicopathological features were summarized.
RESULTS: Premalignant or malignant neoplasms accounted for 4.5% of all specimens submitted with cysts in the clinical differential. Most
cyst-mimicking cancers were basal cell carcinoma (BCC) or squamous cell carcinoma (SCC); however, cancers with poorer prognoses, such as Merkel cell carcinoma and melanoma, also clinically masqueraded as cysts. The BCCs were predominately nodular, and the SCCs were largely well-differentiated and invasive. Many exhibited clinical signs and symptoms compatible with benign cysts, such as central punctum, pain, and rapid growth. Identified risk factors included history of prior non-melanoma skin cancer diagnosis, previous excision, and immunosuppression.
CONCLUSIONS: Many lesions clinically concerning cutaneous cysts were found to be malignancies following histopathological
review. Accordingly, following biopsy all
cyst-like lesions should be examined microscopically, especially in certain clinical contexts in which the incidence of skin cancer is increased.