광선각화증에 병발한 Merkel 세포암 1예

초록

An 87-year-old woman developed a half-walnut sized bluish-red, protruding nodule on the vertex scalp. It was an easily bleeding nodule surrounded by a violaceous patch, which had been diagnosed as actinic keratosis by histologic examination in a hospital two months earlier. The incisional biopsy showed round tumor cells with scanty cytoplasm forming trabeculae or diffuse infiltration mimicking malignant lymphoma. In immunohistochemical staining, NSE, chromogrannin and cytokertins were positive. Electron microscopic examination showed variable numbers of peripherally arranged, membrane-bound, dense core neurosecretory granules in the cytoplasm of tumor cells. This tumor was diagnosed as Merkel cell carcinoma and was excised with a 2.5cm safety margin. She has shown no recurrence or regional metastasized lesion until now, 1-year has passed.

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