儿童黑色素瘤的病理分析:附4例报告

目的:探讨儿童黑色素瘤的临床病理特征、诊断和鉴别诊断。方法:对4例儿童黑色素瘤的病理切片行苏木精-伊红及免疫组织化学染色并于镜下观察,结合文献复习,分析其临床病理特征。结果:4例黑色素瘤的病理形态有明显多形性及多样性,镜下可见瘤细胞呈上皮样或梭形,部分瘤细胞胞浆内可见黑色素颗粒。免疫组织化学标记显示,S-100蛋白、HMB45和A103均为阳性,核增殖指数Ki-67为15%~40%。结论:儿童黑色素瘤极为罕见,容易误诊和漏诊,应与Spitz痣、蓝痣和先天性黑色素细胞痣中的增生性结节等鉴别。

Clinicopathological Analysis of Malignant Melanoma in Children. a Report of 4 Cases

Objective：To study the clinicopathological characteristics, diagnosis and differential diagnosis of malignant melanoma in children. Methods： A total of 4 cases of malignant melanoma in children had been enrolled. The pathological sections were observed under the microscope after hematoxylin-eosin and immunohistochemical staining. The clinical and pathologic features were analyzed and the related literatures were reviewed. Results： Four cases of malignant melanoma in children were characterized by obvious heterogeneous histologic phenotypes. The melanocytes could be epithelioid or spindle and a few of cells had melanin granules in the cytoplasm. The tumor cells were positive for S-100 protein, HMB45 and A103, and Ki-67 index was 15%-40%. Conclusions： Malignant melanoma in children is rare and easier to be misdiagnosed or missed. It needs to be distinguished from Spitz nevus, blue nevus, and proliferative nodule in congenital melanocytic nevus.