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Triphasic differentiations of Merkel cell carcinoma in primary and metastatic lesions
Author(s) -
Koba Shinichi,
Misago Noriyuki,
Nagase Kotaro,
Tsuruta Noriko,
Inoue Takuya,
Ikeda Satoshi,
Aoki Shigehisa,
Narisawa Yutaka
Publication year - 2014
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.12289
Subject(s) - pathology , merkel cell , merkel cell carcinoma , immunohistochemistry , biology , stem cell , carcinoma , medicine , genetics
We present a rare case of Merkel cell carcinoma ( MCC ) with heterologous differentiation. The patient was an 86‐year‐old female patient with MCC who presented with a forearm skin tumor and left axillary lymph node swelling. Histopathologically, the malignant components of the primary and metastatic lesions showed the intermingled features of triphasic phenotype differentiation, which had distinct cell populations; MCC , sweat gland carcinoma ( SGC ) and malignant poorly differentiated spindle cells with myogenic differentiation were immunohistochemically showed. Moreover, an electron microscopic observation of the tumor cells revealed intracytoplasmic canaliculi and junctional structures that indicated ductal differentiation. To our knowledge, this is the first case of MCC admixed with SGC and sarcomatous components in both the primary and metastatic lesions. An immunohistochemical study, using several stem cell markers, indicated that the MCC arose from pluripotent epidermal stem cells.