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汗腺腺癌(Hidradenocarcinoma)临床罕见,且组织病理形态复杂多变易误诊。本文报告1例头皮汗腺腺癌广泛累及颞骨,引起耳聋、耳鸣、眩晕和周围性完全性面瘫。病理观察,瘤组织主要为体积较大的多边形细胞,胞膜清晰,胞浆透明,核呈圆形,椭圆形或多角形,浓染、大小不一,并有1～2个核仁。有病理性核分裂相,间变明显,PAS染色示细胞周边有大量PAS阳性物质,瘤细胞呈片块状分布,其间有纤维组织分隔。局部可见腺腔结构,管壁为1～2层立方形细胞,PAS染色见有沿管腔PAS阳性角质膜。外周有肌上皮细胞,管腔直径为40～200μm,腔内有嗜伊红角质物和细胞碎屑。瘤组织有明显坏死和炎性肉芽组织。患者确诊后半年死于颅内转移和脑膜炎。
Hidradenocarcinoma is rare in clinical practice, and its histopathology is complicated and changeable. This article reports a case of scalp sweat adenocarcinoma involving the temporal bone, causing deafness, tinnitus, dizziness and peripheral complete facial paralysis. Pathological observation, the tumor mainly polygamous cells with larger volume, clear cell membrane, cytoplasm transparent, the nucleus was round, oval or polygonal, thick dye, different sizes, and 1 to 2 nucleoli. Pathological mitotic phase, between the obvious change, PAS staining showed a large number of PAS-positive cells around the tumor cells were patchy distribution, during which there are fibrous tissue separation. Local visible glandular cavity structure, wall of 1 to 2 layers of cubic cells, PAS staining along the lumen PAS positive corneal. Peripheral myoepithelial cells, lumen diameter of 40 ~ 200μm, intracellular eosinophilic horn cells and cell debris. Tumor tissue necrosis and inflammatory granulation tissue. Six months after the diagnosis of patients died of intracranial metastases and meningitis.