23例鼻腔鼻旁窦恶性黑色素瘤临床病理分析  

CLINICOPATHOLOGIC STUDY OF 23 CASES OF PARANASAL SINUSE MALIGNANT MELANOMA IN NASAL CAVITY AND PARANASAL SINUSES

作　　者：胡春英[1] 常家辉[2] 张道荣[2] 

机构地区：[1]沈阳市第七人民医院耳鼻喉科,辽宁110003 [2]中国医科大学病理教研室,中国医科大学附属第一医院病理科,沈阳110001

出　　处：《中国组织化学与细胞化学杂志》2009年第5期602-605,共4页Chinese Journal of Histochemistry and Cytochemistry

摘　　要：目的研究鼻腔鼻旁窦恶性黑色素瘤的临床及病理特征。方法采用免疫组化SP方法对23例鼻腔鼻旁窦恶性黑色素瘤的临床及病理进行分析。结果23例鼻腔鼻旁窦恶性黑色素瘤中,男性15例(65.2%),女性8例(34.8%);最大年龄80岁,最小年龄45岁,平均年龄57岁;位于鼻腔19例(82.6%),鼻旁窦4例(17.4%),临床表现全部为鼻肿物;病理组织学类型,小圆细胞型12例(52.2%),上皮样细胞型8例(34.8%),梭形细胞型2例(8.7%),多形性细型胞1例(4.3%);含有黑色素13例(56.5%),无黑色素10例(43.5%):免疫组化染色,Vimentin,23例全部呈阳性反应,阳性率为100%,S-100和HMB45呈阳性反应的都为21例:阳性率都为91.3%,MelanA 19例呈阳性反应,阳性率占82.6%。结论23例鼻腔鼻窦恶性黑色素瘤,临床主要表现为鼻肿物,发病部位大多数在鼻腔,联合应用S-100,HMB45和MelanA弥漫阳性在与其组织学相似的肿瘤鉴别中是诊断鼻腔鼻窦恶性黑色素瘤的重要标准。Objective To study the clinicopathologic changes of nasal malignant melanoma. Methods S-P immunohistochemical study was used in 23 cases Results The tumor arose in 15 males and 8 females, 45-80 years of age （mean 57 years）. The majority of tumors involved the nasal cavity. All cases present nasal neoplasm. The predominant microscopic appearance was categorized as small rounded cell type in 12 cases （52.2%）, epithelioid type in 8 cases （34.8%） , spindle cell type in 2 cases （8.7%） , and pleomorphic type in 1 case （4.3%）. 13 cases contained melanin pigment （56.5%） , while 10 cases didn＇t （43.5%） ; 21,21 and 19 cases were immunoreactive to anti-S-100 protein, HMB45 and melan A antibodies respectively. Conclusion Diffuse immunopositive reaction to S- 100, HMB45 and melan A is a highly important standard in the differential diagnosis of nasal sinuse malignant melanoma from histologically similar neoplasms.

关 键 词：鼻腔 鼻窦 恶性黑色素瘤 S-100 HMB45 Melan A 

分 类 号：R322.3[医药卫生—人体解剖和组织胚胎学]