肛管恶性黑色素瘤5例临床病理分析

目的：探讨肛管恶性黑色素瘤临床病理学特点、诊断及鉴别诊断。方法：对5例肛管恶性黑色素瘤进行临床资料分析,病理形态观察及免疫组织化学检测。结果：肛管恶性黑色素瘤临床表现为直肠出血、肛门疼痛及肿块形成。瘤细胞呈上皮样、梭形,部分区域见透明样肿瘤细胞,细胞形态明显异型,可见大的嗜酸性核仁,核分裂像易见,并见病理性核分裂像,部分胞质内见黑色素。瘤组织呈巢状、条索状、腺泡状排列。肿瘤细胞表达V imetin、Melan-A、S-100、HMB-45。结论：肛管恶性黑色素瘤临床表现无明显特异性,病理诊断及免疫组织化学对诊断有重要意义。

Clinicopathologic Features and Differential Diagnosis of 5 Cases Anorectal Melanoma

Objective： To discuss the clinicopathologic features and differential diagnosis of anorectal melanoma.Method： Were analyzed clinical data,pathologically and immunohistochemically five cases of anorectal melanoma.Result： The main complain of all patients was noting rectum bleeding,anal pain and lump.Microscopically the tumor cells of anorectal melanoma were arranged in nests,cords and acinar form.The tumor was composed of epitheliod to spindle-shaped cells with large nuclei,prominent cherry red nucleoli and abundant pink or clear cytoplasm.In some instances melanin might be seen.Mitotic figures are numerous.Immunohistochemically,the tumor cells were positive for vimentin,melan-A,s-100,HMB-45.Conclusion： Anorectal melanoma is nonspecific in clinic.It is easily misdiagnosed.Diagnosis and differential diagnosis rely mainly on the histology and immunohistochemically.