对1例皮肤小汗腺螺旋腺瘤恶变进行观察,形态学分析及免疫组织化学染色,结合文献分析其临床病理特征.患者,女,58岁,发现左下腹部皮肤肿物30多年.B超探及一大小约2.1 cm×1.8 cm的囊壁回声结节,囊实性,界清,边界完整.镜下示肿瘤位于真皮深层,呈囊实性,大部分区域呈典型良性螺旋腺瘤形态,但肿瘤细胞核质比增高,核分裂象易见,局部发生恶性变.免疫组织化学方面,肌上皮的减少或丧失以及Ki-67的高表达有助于确诊.皮肤螺小汗腺旋腺瘤恶变罕见,熟悉其组织学特点有助于正确诊断.%One case of malignant transformation in eccrine spiradenoma was analyzed on image observation,morphological analysis with review of the literature.A 58-year-old female patient suffered from a cutaneous mass on her left lower abdominal wall for 30 years.Ultrasonography revealed a demarcated heterogeneous-echoic solid mass containing cystic change.It was encapsulated with a 2.1 cm × 1.8 cm nodule attached in the cystic wall.Histologically,the tumor was located in deep dermis.In its solid part,a classic benign spiradenoma was identified.The malignant transformation,however,was recognized in focal area.Those cancer cells were atypical and with high N/C ratio.Immunohistochemically,decrease or loss of myoepithelial and highly expression of Ki-67 were the key to diagnosis.Eccrine spiradenoma with malignant transformation is rare.Familiarity with its histologic characteristics is helpful to making correct diagnosis.
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