疾病定義與分類
- 過去曾有人主張陰莖 (penis) 皮膚從不形成蟹足腫 (keloid)，但已有在包皮環切術 (circumcision) 後及其他形式創傷 (trauma) 後發生的報告，其發生率可能比一般所懷疑者更為常見。
- 在陰莖背側 (dorsum of the penis) 曾出現由保險套導尿管 (condom catheter) 所致慢性水腫 (chronic edema) 模擬之蟹足腫病灶 (Fig. 12.282)。
組織病理特徵 (Histopathology)
- 低倍鏡 (low-power) 檢查可見一息肉狀 (polypoid)、常帶蒂 (pedunculated) 的病灶，具纖維血管性間質 (fibrovascular stroma)，細胞密度 (cellularity) 不一。
- 厚壁 (thick walls) 的中小型血管甚為明顯 (Fig. 12.283)。
- 低細胞性 (hypocellular) 腫瘤含豐富膠原 (collagen)，僅有散在分布的紡錘形 (spindle-shaped) 或星狀 (stellate) 細胞，呈現輕度局灶性或無細胞學異型性 (cytological atypia)，並可見偶發至常見的多核細胞 (multinucleated cells)。
- 隨腫瘤細胞密度增加，細胞學異型性 (cytological atypia) 更為顯著，且有絲分裂象 (mitotic figures) 可能甚為明顯 (Figs 12.284 and 12.285)。
圖 12-282：慢性水腫 (chronic edema) 模擬蟹足腫 (keloid)：注意近端背側腫脹 (dorsal proximal swelling) 與腹側尿道瘻管 (ventral urethral fistula)。承蒙 Dr Rameshwar Bang（Safat, Kuwait）提供。轉載自 Bang R.L. Penile edema induced by continuous condom catheter use and mimicking keloid scar. Scand J Urol Nephrol 1994;28:333–5。引自 Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004。
Fig. 12.282 Chronic edema simulating a keloid: note the dorsal proximal swelling and ventral urethral fistula. Courtesy of Dr Rameshwar Bang, Safat, Kuwait. Reproduced from Bang R.L. Penile edema induced by continuous condom catheter use and mimicking keloid scar. Scand J Urol Nephrol 1994;28:333–5. From Bunker C. Male Genital Skin Disease. Saunders Ltd./Elsevier 2004.
圖 12-283：纖維上皮性間質息肉 (fibroepithelial stromal polyp)：可見厚壁血管 (thick-walled vessels) 伴隨細胞密度不一的疏鬆結締組織間質 (variably cellular loose connective tissue stroma)。承蒙 M. Nucci, MD（Brigham and Women’s Hospital and Harvard Medical School, Boston, USA）提供。
Fig. 12.283 Fibroepithelial stromal polyp: there are thick-walled vessels associated with a variably cellular loose connective tissue stroma. By courtesy of M. Nucci, MD, Brigham and Women’s Hospital and Harvard Medical School, Boston, USA.
圖 12-284：纖維上皮性間質息肉 (fibroepithelial stromal polyp)：此視野中可見顯著的核異型性 (nuclear atypia)。承蒙 M. Nucci, MD（Brigham and Women’s Hospital and Harvard Medical School, Boston, USA）提供。
Fig. 12.284 Fibroepithelial stromal polyp: in this field, there is striking nuclear atypia. By courtesy of M. Nucci, MD, Brigham and Women’s Hospital and Harvard Medical School, Boston, USA.