肛管直肠恶性黑色素瘤6例的临床病理分析

目的探讨肛管直肠恶性黑色素瘤(AMM)的临床病理特征,对其诊断和鉴别诊断进行讨论。方法观察组织形态学结构并结合免疫组化的方法,对6例AMM进行临床病理分析。结果 AMM患者的主要临床症状为排便习惯改变、便血、肛门口脱出肿物、肛门坠胀和肛周疼痛。肿瘤由多种类型细胞组成,如上皮样、梭形及未分化小细胞等。免疫组化标记瘤细胞:HMB45、S-100蛋白、Vim均(+)。6例患者全部误诊。结论 AMM是一种相对少见、恶性度极高的肿瘤,临床误诊率高。

Clinicopathologic Analysis on 6 Cases of Anorectal Malignant Melanoma

[Objective]To explore clinicopathologic features of anorectal malignant melanoma （AMM）,discuss its diagnosis and differential diagnosis.[Methods]With the combination of histomorphology observation and immunohistochemistry,clinicopathologic analysis was performed in 6 cases of AMM.[Results]The main clinical symptom of AMM patients were change of defecation habit,hematochezia,visible or palpable mass in the anus,straining and pain around the anus.The tumor was composed of various cell types,such as epithelioid cell,spindle cell and undifferentiated small cell.Immunohistochemical results showed the tumors were positive for HMB-45,S-100 and vimentin.All of 6 cases were misdiagnosed.[Conclusion]AMM is a rare tumor and highly malignant tumor.It is easily misdiagnosed in clinical practice.