惡性変化を伴つた増殖性毛嚢嚢腫の1例

PROLIFERATING PILAR CYSTS WITH PARTIAL MALIGNANT CHANGE

I．緒言

　Sebaceous cystの嚢壁細胞はMcGavran　＆　Bennington^1）により毛嚢細胞であることが証明され，またその良性増殖型腫瘍の特長はJones^2）により明確にされた。毛根鞘腫瘍におけるclear　cellの出現はHaedington　＆　French^3）の症例に見られる。最近，著者等は澄明細胞の胞巣性増殖を伴い，他方浸潤性転移巣をも示す毛嚢性腫瘍の1例を経験したので，以下その大要を述べると共に，旧来の粉瘤癌あるいは毛嚢癌等との関連について考察を加える。

A tumor developed on the burn scar of a 67-year-old man's scalp after trauma. Its histologic diagnosis 2 months after injury was squamous cell carcinoma. The spherical and reddish-yellow tumor with coarse granular surface became 4×2×1 cm. in size, 3 months after trauma. No invasion or metastasis into the surrounding skin and regional lymphnodes was proved.

Histologic specimen was composed of epithelial cell nests well marginated by connective tissue. In the upper part of the tumor the nests showed cord-shaped or alveolar structure, some of which had conection with the nests in the middle and lower parts of the tumor. The nests were composed of hair sheath cells, in the center of which contained horny material, sudanophilic fine granular substance and nuclear debris. Some parts of the nests were composed purely of clear cells. The nests in the middle and lower parts of the tumor were small cyst-like, some of which raptured and were surrounded by inflammatory infiltration with giant cells. Some tumor cell were invading and growing from these nests into connective tissue. The tumor cell infiltration was noted in perineural lymph spaces and under the galea aponeurotica.

The arrangement of the tumor cells, keratinization and cavity formation contaning nuclear debris, existence of clear cell nests and occurrence on the burn scar were chracteristics for this disease. This entity is derived from hair follicle and should be separated from the squamous cell carcinoma of the epidermis.