20例恶性黑色素瘤的临床病理分析

目的探讨恶性黑色素瘤的临床病理学特征.方法采用HE染色和免疫组化标记,对20例恶性黑色素瘤进行临床病理分析.结果恶性黑色素瘤临床表现复杂,容易误诊,本组有10例诊断为慢性溃疡.光镜下形态以多种细胞类型和组织形态混合存在为主要特征,细胞类型可分为;上皮样细胞、梭形细胞、透明细胞及瘤巨细胞,瘤细胞排列:上皮样细胞呈实性巢状或片状,有时可呈腺泡状,梭形细胞呈束状、编织状或漩涡状,透明细胞、瘤巨细胞呈小区成群或分散混合在其它瘤细胞间.免疫组化染色显示本瘤S-100蛋白、Vimentin、HMB45阳性率分别为95%、90%、90%,CK阴性.免疫组化的应用对提高本瘤的诊断与鉴别诊断有较高的应用价值.结论恶性黑色素瘤临床表现复杂,其诊断及鉴别诊断主要依靠靠病理学、免疫组化.

A Clinicopathologic Study On 20 cases of Malignant Melanoma

Objective To explore the clinicopathologic features of melanoma. Method Among 20 cases of melanoma, the clinioo-pathologic analysis had been done by the means of HE staining and immunohistochemistry label. Results The manfesation of melanoma were quite complicated and easily lead to misdiagnosis 10 cases in this group had been diagnosed as chronic ulcer. The main features of melanoma under light microscopy were multiple cells type and histological features co-existing. The cells type include epithelioid cell, spindle cell, hylocyte, tumor giant cell. The arrangement of this tumor cells demonstrated that the epithelioid cells arranged in nets or flakes, and adeniform in some cases, spindle cells arranged in cords, laciform pattern or whirlpool pattern, The hylocyte and tumor giant cells arranged in groups or scattered over other tumor cells. The immunohistochemistry showed that for the melanoma the positive rate of s-100 protein, Vimentin, HMB45 were 95%, 90%, 90% respectively. CK was negative. Conclusions The immunohistochemistry can strongly improve the diagnosis and differential diagnosis of melanoma which should be based on pathological analysis and immunohistochemistry.