Merkel cell carcinoma with partial spontaneous regression: an immunohistochemical, ultrastructural, and TUNEL labeling study.
We report a case of Merkel cell carcinoma that partially regressed after biopsy. A 76-year-old woman presented with an 1 month history of a rapidly enlarging nodule on her left cheek. After biopsy, the nodule reduced to almost half the size and was excised 1 month later. The excised specimen showed a dense cluster of lymphocytes and fibrosis around the tumor nests. In addition, lymphocytes showed apposition with tumor cells. An immunohistologically dense, even infiltration of CD4+ and CD8+ cells was found around the tumor nests, and more CD8+ cells than CD4+ cells were seen in the tumor nests. By electron microscopy (EM), apoptosis of tumor cells and lymphocytes was observed. Many apoptotic cells were also detected by in situ nick end-labeling (TUNEL) of DNA-breaks, especially in the marginal area of tumor nests surrounded by dense lymphocytic infiltrates. It seems likely that T-cell immunity, which induces apoptosis of tumor cells, may have been involved in tumor regression.
Takenaka
H
H
Department of Dermatology, Kyoto Prefectural University of Medicine, Japan.
Kishimoto
S
S
Shibagaki
R
R
Nagata
M
M
Yasuno
H
H
D000368:Aged; D017209:Apoptosis; D001706:Biopsy; D015266:Carcinoma, Merkel Cell / Q000473:pathology*; D005260:Female; D005821:Genetic Techniques; D006801:Humans; D007150:Immunohistochemistry; D009365:Neoplasm Regression, Spontaneous; D012867:Skin / Q000166:cytology / Q000473:pathology / Q000648:ultrastructure; D012878:Skin Neoplasms / Q000473:pathology*