转移性恶性黑色素瘤细针吸取细胞学的研究分析  

A Fine Needle Aspiration Cytological Study of 26 Cases

作　　者：尹艳华[1] 于钢 

机构地区：[1]聊城市人民医院,山东聊城252000 [2]聊城市肿瘤医院,山东聊城252000

出　　处：《实用医技杂志》2007年第19期2537-2539,共3页Journal of Practical Medical Techniques

摘　　要：目的:探讨转移性恶性黑色素瘤细针吸取细胞学形态特点,提高诊断和鉴别诊断的能力,以防漏诊。方法:选取原发灶已被病理组织学证实,并且淋巴结穿刺已做细胞块的恶性黑色素瘤患者26例,进行光镜观察细胞形态学特征,并用细胞块做免疫细胞化学染色标记。结果:26例转移性恶性黑色素瘤中,细针吸取细胞学对恶性肿瘤诊断准确率达100%,20例黑色素颗粒比较明显,细胞学直接诊断为恶性黑色素瘤,6例无色素及色素很少,其中4例以上皮样细胞为主,细胞学诊断为腺癌,2例细胞呈多形性以梭形细胞为主,诊断为多形性肉瘤。细针吸取细胞学检查诊断恶性黑色素瘤的准确率达78%。肿瘤细胞HMB45,S-100均阳性表达。结论:转移性恶性黑色素瘤的细胞形态学变化有显著的多样性,细针吸取细胞学对淋巴结转移无色素的恶性黑色素瘤诊断比较困难,利用细胞块进行免疫细胞化学染色,再结合临床资料,能大大提高转移性恶性黑色素瘤诊断准确率。objective Approach of the cytological characteristic of metastatic malignant melanoma by FNA and differential diagnosis with other soft tissue tumor. Methods 26 cases of metastatic malignant melanoma confirmed by pathologic histology and lymph node FNAB cell block, cyto-morphology and cell block lmmunocy to chemical stain were observed. Results All 26 cases were diagnosed of metastatic malignant tumor. 20 cases have obviously melanin granule and make a direct diagnosis. 6 cases lack of melanin granule, including 4 cases with epithelioid cell features and make a diagnosis of metastatic adencarcinoma, 2 cases with pantomorphia and spindle cell features, make a diagnosis of pantomorphic sarcoma. the FNAB in diagnosis of metastatic malignant melanoma had a accurary of 78%. positive Expression of HMB45 and S-100 in tumor cell of all cases. Conclusion There are many variety cytological characteristic of metastatic malignant melanoma, it＇s difficult to make a diagnosis for which lack of melanin granule by FNAB./mmunocytochemical stain in cell block and refer to clinical data can improve the accurary diagnosis of metastatic malignant melanoma.

关 键 词：恶性黑色素瘤 细针吸取 细胞学 

分 类 号：R739.5[医药卫生—肿瘤]