恶性黑色素瘤59例临床病理分析

目的分析恶性黑色素瘤（MM）的临床，病理形态特点，并阐明其诊断和鉴别诊断要点。方法对59例MM进行临床病理学，部分病例做组织化学和免疫组织化学观察，并复习其临床资料。结果临床正确诊断发生在皮肤45例中仅14例，占32％，发生在粘膜14例中仅3例，占21％。其余均误诊。在病理形态上肿瘤以多种细胞类型和组织形态混合存在为主要特点外，16例无色素性恶性黑色素瘤（AMM）做Fontana染色均阳性。其中8例做免疫组化检测，大部分符合本瘤诊断。其中2例误诊，结论认识MM的临床病理特点，免疫组化：HMB45、S－100蛋白，VIM、CK四种标记联合应用，对MM尤其是对AMM的诊断和鉴别诊断有实用价值，应推广使用。

The Chinicopathologic Analysis of Fifty-nine Cases of Malignant Melanoma

Objective To study the signs, symptoms and pathologic features of malignantmelanoma (MM),the author described the key to the diagnosis and differentiation of MM. MethodsFifty-nine cases Of surgically resected MM were analysed by histopathology, histochemistry and immuno-histochemistry partly. Results There were 14 of 45 cases of MM in skin diagnosed correctly(32%)and3 of 14 in membrane(21% ). Their main histopathogic feature was the mixture of various histopatholo- gy. Sixteen cases of AMM were identified with Fontana' S stain and 8 cases of AMM were diagnosed byimmunohistochemistry. Conclusion The authors think it is helpful to use combinated method of im- munohistochemistry (HMB45, S-100 protein, VIM and CK) in the diagnosis and differential diagnosisfor MM,especially AMM.