膀胱原发性恶性黑色素瘤1例并文献复习

目的 观察原发性恶性黑色素瘤的病理形态、免疫组化和电镜特征,进一步探讨其组织起源和鉴别诊断,指导临床诊治.方法 用组织病理学、免疫组化、透射电镜方法进行观察,并结合国外文献资料进行探讨.结果 肿瘤位于膀胱黏膜下,瘤细胞呈巢状或弥漫排列,具有一定异型性,部分为透亮型,部分为小细胞型,靠近边缘的肿瘤细胞呈梭形伴黑色素沉着....

Primary melanoma of urinary bladder:a case report and review of literature

Objectives To elucidate the morphologic,immunohistochemical,eleclron microscopical features and the histogenesis of primary malignant melanoma in urinary bladder, to direct clinical therapy. Methods One case of malignant melanoma of urinary bladder was obsenred with application of histopathologic, immunohistochemical and electron microscopical methods and review of the literatures. Results Morphologically, the tumor located under the urinary bladder mucosa,the tumor cells were small round,clear,and arranged in small nests or diffuse sheets with atypical. spindal cells with pigmentation were obsenred in the tumor margin. Immunohisrochemically, HMB45,Melan A,S- 100 and P53 were positive, Ki -67 >40% ,but CK,CK18 ,CK8 and CK7 were negative. Under eleeron microscope, the tumor cells junctions were sparse, poorly developed, nucleoli had a coiled structure with atypia. There were melanosomes in some tumor cells and much of the cytoplasm was occupied by difuse zones of glycogen. Conclusions Primary malignant melanoma of urinary bladder is a rare tumor. The histogenesis remains controversial,probably from melanocytic ectopia or embryonic remains, argyrophil cells in nomal urothelium and the memplasia of nomal urothelium. The main therapeutic method is wide resection,and the effect will be improved to combine chemical therapy or immunotherapy or radiotherapy reasonably.