目的 探讨皮肤淋巴上皮瘤样癌（LECS）的临床和病理特征,提高临床诊断和治疗水平。方法 对1例LECS患者的临床表现、手术标本大体病理形态、组织学表现和免疫组化表型进行分析,并结合文献复习。结果 患者为老年男性,左面颊1.3 cm大小暗红色质硬结节状皮损,切面实性,无明显包膜。免疫组化显示肿瘤细胞P-CK、CK5/6、EMA（+）,S100和CDlα（部分+）,Ki-67（+40%）,PD-L1（+50%）,P40、Melan-A、CEA（-）;瘤细胞周围增生的淋巴细胞LCA弥漫（+）,癌巢内及周边淋巴细胞以CD3阳性的T淋巴细胞为主。瘤细胞EBER原位杂交阴性反应。结论 面部皮肤淋巴上皮瘤样癌极为罕见,病理形态和免疫组化表型与其他部位者相似,EBER检查有鉴别诊断价值。肿瘤治疗首选局部完整切除,预后相对较好。
Objective To investigate the clinical and pathological features of lymphoepithelioma-like carcinoma of the skin （LECS） and improve clinical diagnosis and treatment of the disease. Methods The clinical manifestations, gross pathological morphology, histological features, and immunohistochemical phenotype of a patient with LECS were analyzed, and the related literature was reviewed. Results The patient was an elderly male with a 1.3 cm dark red hard nodular lesion on the left cheek. The nodule was solid and without obvious capsule. Immunohistochemical results showed that the tumor cells were stained positive for P-CK, CK5/6, EMA, S100 and CD1α （partial positive expression）, Ki-67 （40%）, and PD-L1 （50%）, and negative for P40, Melan-A, and CEA. The proliferative lymphocytes around the tumor cells were diffuse positive for LCA, and the lymphocytes in and around the cancer nest were mainly CD3 positive T lymphocytes. EBER in situ hybridization of tumor cells was negative. Conclusion LECS on the check is very rare, and its pathological morphology and immunohistochemical phenotype are similar to those in other sites. EBER examination is valuable in differential diagnosis. Local complete resection is the first choice for the treatment of the tumor, and the prognosis is relatively good.
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