皮肤恶性黑色素瘤临床病理及免疫组化研究

目的：研究皮肤恶性黑色素瘤（简称恶黑）的临床病理特点及免疫组化染色在恶黑诊断中的作用。方法：对６８例皮肤恶黑的临床及病理资料进行回顾性研究，其中３２２列用免疫组化ＳＰ法作Ｋｅｒａｔｉｎ、Ｖｉｍｅｎｔｉｎ、Ｓ－１００、ＨＭＢ－４５等染色。结果：皮肤原发性恶黑１６．１８％有明确的外伤史，２５％有色素痣史。临床初诊恶黑３２例，误诊为其它病变的３６例。上皮样细胞为主型３２例，梭型细胞为主型２５例，痣细胞样

Clinicopathological and immunohistochemicalstudy of cutaneous malignant melanomas

Objective:To study clinicopathologcal features of cutaneous malignant melanomas and the role of immunohistochemical stain in diagnosis.Method:Retrospective clinicopathological materials of 68 cases of cutaneous malignant melanomas were studied.Expressions of Keratin,Vimentin,S-100,HMB-45 were detected by immunohistochemistry SP method in 32 cases of cutaneous malignant melanomas.Result:11 of 68(16.18%) cutaneous malignant melanomas developed in sites which had been injured,17 of 68(25%) melanomas occured in previous melanocytic nevi.Of the 68 melanomas there were 32 with essential epitheliod cells,25 with mainly spindle cells,9 with nevus cells,2 with balloon clear cells.All 32 cases of melanomas in skin were negative to Keratin,but positive to Vimentin and S-100.29 of 32 (90.63%) melanomas were positive to HMB-45 and the other 3 were negative.Conclusion:Cutaneous malignant melanomas may result from injury and melanocytic nevi.Malignant melanoma of foot was easily misdiagnosed because of its shelter.Because the morphology and histology of cutaneous malignant melanomas were very complex,immunohistochemical stains(Keratin,Vimentin,S-100,HMB-45) and eletronmicroscopic detection were helpful for diagnosis of malignant melanoma.