■皮肤皮脂腺瘤包括从良性腺瘤到恶性肿瘤的一系列疾病。这些病变的标志是皮脂腺分化。然而,低分化皮脂腺癌(SC),缺乏明显的皮脂腺分化,可以显示与各种其他基底细胞样皮肤肿瘤的形态重叠。SC的准确分类不仅对诊断至关重要,但也因为与Muir-Torre综合征的潜在关联。雄激素受体(AR)是一种敏感、但并非用于SC诊断的完全特异性免疫组织化学标记物。在MELanoma(PRAME)中优先表达的抗原显示出成熟皮脂腺细胞的强细胞质标记,并且据报道在多种皮脂腺肿瘤中表达,包括在基底细胞组件中。因此,我们试图比较细胞质PRAME表达与AR的诊断用途,以区分SC和基底细胞样皮肤模拟物;即基底细胞癌,基底细胞样鳞状细胞癌,pilomatricoma,皮肤淋巴腺瘤,和乳腺外Paget病.我们报道细胞质PRAME表达在低分化SC中并不常见,虽然具体,它显示非常低的灵敏度(22%)。相比之下,AR对SC与基底细胞模拟物的区别具有中等敏感性(66%)和高度特异性(92%)。这些属性,除了在SC的皮囊细胞和基底细胞成分中AR的核表达外,提示AR对SC的诊断优于PRAME。
UNASSIGNED: Cutaneous sebaceous neoplasia comprises a spectrum of disease ranging from benign adenomas to malignant carcinomas. The hallmark of these lesions is sebaceous differentiation. However, poorly-differentiated sebaceous carcinoma (SC), which lacks significant overt sebaceous differentiation, can show morphologic overlap with a variety of other basaloid cutaneous neoplasms. The accurate classification of SC is essential not only for diagnosis, but also because of the potential association with Muir-Torre syndrome. Androgen receptor (AR) is a sensitive, but not entirely specific immunohistochemical marker that has been used for the diagnosis of SC. PReferentially expressed Antigen in MElanoma (PRAME) demonstrates strong cytoplasmic labeling of mature sebocytes and has been reported to be expressed in a variety of sebaceous neoplasms, including in the basaloid cell component. Therefore, we sought to compare the diagnostic use of cytoplasmic PRAME expression with that of AR for the distinction of SC from a cohort of basaloid cutaneous mimics; namely basal cell carcinoma, basaloid squamous cell carcinoma, pilomatricoma, cutaneous lymphadenoma, and extra-mammary Paget disease. We report that cytoplasmic PRAME expression is uncommon in poorly differentiated SC, and although specific, it shows very low sensitivity (22%). In contrast, AR was moderately sensitive (66%) and highly specific (92%) for the distinction of SC from basaloid mimics. These attributes, in addition to the nuclear expression of AR in the sebocytic and basaloid components of SC, suggest that AR is superior to PRAME for the diagnosis of SC.