24294397 Visualization

A 67 Age - year Age - old Age Japanese Personal_background female Sex presented Clinical_event with a left Biological_structure buttock Biological_structure tumor Sign_symptom , which had been first detected approximately 1 Date year Date earlier Date , and had recently gradually Detailed_description enlarged Detailed_description .
Physical Diagnostic_procedure examination Diagnostic_procedure revealed a relatively well Detailed_description - circumscribed Detailed_description skin Color - colored Color tumor Sign_symptom with hyperkeratosis Detailed_description , measuring 43 Area x Area 38 Area mm Area in Area diameter Area , in her left Biological_structure buttock Biological_structure .
The biopsy Diagnostic_procedure specimen revealed Bowen’s Disease_disorder disease Disease_disorder ( squamous Disease_disorder cell Disease_disorder carcinoma Disease_disorder in Disease_disorder situ Disease_disorder ), and subsequently, total Detailed_description resection Therapeutic_procedure of the tumor Sign_symptom was performed.
Histopathological Diagnostic_procedure study Diagnostic_procedure of the resected specimen revealed proliferation Sign_symptom of atypical Detailed_description squamous Detailed_description cells Detailed_description in the entire layer of the acanthotic Sign_symptom epidermis Biological_structure accompanied by hyperparakeratosis Sign_symptom (Figure 1A).
These atypical squamous Biological_structure cells Biological_structure had enlarged Lab_value and hyperchromatic Lab_value nuclei Diagnostic_procedure (Figure 1B), and multinucleated Sign_symptom atypical squamous Biological_structure cells Biological_structure were also present.
Mitotic Sign_symptom figures Sign_symptom were scattered and present in the upper Biological_structure portion Biological_structure of Biological_structure the Biological_structure epidermis Biological_structure .
Atypical mitotic Sign_symptom figures Sign_symptom were also observed (Figure 1B).
No invasive Detailed_description neoplastic Sign_symptom growth Sign_symptom was noted (Figure 1A).
Approximately 95% Quantitative_concept of the lesion Sign_symptom was composed of the above-mentioned Bowen’s Disease_disorder disease Disease_disorder ( squamous Disease_disorder cell Disease_disorder carcinoma Disease_disorder in Disease_disorder situ Disease_disorder ), and superficial Detailed_description sebaceous Disease_disorder carcinoma Disease_disorder was present in the central Detailed_description area Detailed_description of the lesion Sign_symptom .
This latter component was composed of proliferation of nests of atypical cells Sign_symptom with Sign_symptom vacuolated Sign_symptom clear Sign_symptom cytoplasm Sign_symptom and large nuclei Sign_symptom containing Sign_symptom conspicuous Sign_symptom nucleoli Sign_symptom (Figure 1C, ​,1D).1D).
Sebaceous Disease_disorder carcinoma Disease_disorder had invaded Sign_symptom into the superficial Biological_structure reticular Biological_structure dermis Biological_structure (Figure 1C).
Moreover, atypical cells Sign_symptom containing Sign_symptom vacuolated Sign_symptom cytoplasm Sign_symptom were present within the lesion of Bowen’s Disease_disorder disease Disease_disorder adjacent to the sebaceous Disease_disorder carcinoma Disease_disorder (Figure 1E).
Immunohistochemical Diagnostic_procedure studies Diagnostic_procedure were performed using an autostainer Detailed_description ( Ventana Detailed_description ) by the same method as previously reported [9-12].
Epithelial Diagnostic_procedure membrane Diagnostic_procedure antigen Diagnostic_procedure ( EMA Diagnostic_procedure ), cytokeratin Diagnostic_procedure 7 Diagnostic_procedure , and adipophilin Diagnostic_procedure were expressed Lab_value in the sebaceous Disease_disorder carcinoma Disease_disorder component, but not Lab_value in Bowen’s Disease_disorder disease Disease_disorder (Figure 2A).
Androgen Diagnostic_procedure receptor Diagnostic_procedure was also expressed Lab_value in some of the tumor cells of the sebaceous Disease_disorder carcinoma Disease_disorder , but not Lab_value in Bowen’s Disease_disorder disease Disease_disorder .
Moreover, atypical vacuolated Sign_symptom cells Sign_symptom within the lesion of Bowen’s Disease_disorder disease Disease_disorder were also positive Lab_value for adipophilin Diagnostic_procedure (Figure 2B).
Overexpression Lab_value of p53 Diagnostic_procedure protein Diagnostic_procedure was observed in both the sebaceous Disease_disorder carcinoma Disease_disorder and Bowen’s Disease_disorder disease Disease_disorder .
Accordingly, an ultimate diagnosis of sebaceous Disease_disorder carcinoma Disease_disorder associated with Bowen’s Disease_disorder disease Disease_disorder was made.