原发性宫颈恶性黑色素瘤临床病理观察  

Primary malignant melanoma of cervix: a clinicopathological study of 5 cases of the cervix

作　　者：于晓红[1] 秦赟娜[1] 魏宝秀[1] 付秋风[1] 孙丽萍[1] 张南[1] 钟少武[1] 

机构地区：[1]江西省妇幼保健院病理科,南昌330006

出　　处：《临床与实验病理学杂志》2005年第6期666-668,共3页Chinese Journal of Clinical and Experimental Pathology

摘　　要：目的探讨原发性宫颈恶性黑色素瘤的临床病理特征、鉴别诊断及预后。方法对5例宫颈恶性黑色素瘤通过光镜、免疫组化进行观察和分析,并随访。结果5例平均43.4岁,临床表现为不规则阴道出血或排液,妇检示宫颈菜花状或黑色结节状肿物;镜检示肿瘤细胞异型性大,细胞形态多样,表现为痣样细胞、上皮细胞、梭形细胞或混合细胞。免疫表型:HMB45、M elan-A(MART-1)、tyrosinase、S-100蛋白、vim entin均阳性表达。结论原发性宫颈恶性黑色素瘤恶性程度高,预后差。HMB45、M elan-A(MART-1)、S-100蛋白对恶性黑色素瘤有着重要意义,需要注意与癌、癌肉瘤、淋巴瘤或绒癌相鉴别。Purpose To investigate the clinicopathologic features, differential diagnosis and prognosis of primary malignant melanoma in cervix. Methods The clinicopathologic features and immunophenotype were observed in 5 cases of primary cervical malignant melanoma, and all of them were followed up. Results The average age of 5 patients with primary cervical malignant melanoma was 43.4 years. The clinical manifestation was vaginal bleeding or apocenosis. The gynaecologic inspection indicated that the cervices were cauliflower-like or black nodular-like. Microscopically, the heteromorphism of the tumor cells were great and the morphologic features were various from the nevus-like ceils, epithelioid ceils, spindle ceils to the compound cells. The expression of HMIMS, Melan-A （ MART-1 ）, tyrosinase, S-100 protein and vimentin were all positive. Conclusions Primary malignant melanoma in cervix was highly malignant and the prognosis was poor. HMIMS, Melan-A and S-100 protein play important roles in the diagnosis. It is worth noticing that the disease should be differentially diagnosed among carcinoma, carcinosarcoma, lymphoma and choriocarcinoma. Surgical removal is the first-selected therapy, followed by the chemotherapy composed mainly of dimethyl triazemo imidazole carboxamide （DTIC） and the immunotherapy. Comprehensive therapy may improve the prognosis of the patients.

关 键 词：子宫颈肿瘤 黑色素瘤 免疫组织化学 诊断 鉴别 

分 类 号：R737.33[医药卫生—肿瘤]