皮肤及眼球外原发性恶性黑色素瘤临床病理分析  

Primary Malignant Extra-cutaneous and Extra-ocular Melanoma:Clinicopathological Analysis

作　　者：杨含金 付素娥[2] 严小娟[2] 何勋[2] 陈海玲[2] 石群立[2] 

机构地区：[1]浙江省仙居县人民医院 [2]南京军区南京总医院,210002

出　　处：《实用癌症杂志》2000年第2期139-141,共3页The Practical Journal of Cancer

摘　　要：目的　研究皮肤及眼球外原发性恶性黑色素瘤的临床与病理特征 ,以提高临床早期诊断率。方法　对 18例皮肤及眼球外原发性恶性黑色素瘤进行临床资料分析 ,病理组织学、免疫组化及电镜研究。结果　本组患者平均年龄 5 1.6岁 ,以女性为主。病变部位 :肛管直肠 5例 ,鼻腔及鼻窦 4例 ,口腔粘膜 2例 ,睑结膜、膀胱、阴道、小阴唇、宫颈、骨及乳腺各l例。肿瘤组织学形态多样 ,既象癌又象肉瘤 ,其中 16例可见黑色素颗粒 ,2例为无色素性。免疫组化标记 :肿瘤细胞S-10 0 蛋白 ,HMB 4 5及Vimentin抗体阳性表达。电镜检查 6例均可见不同时期的黑色素小体。结论　恶性黑色素瘤不仅源于体表皮肤的色素细胞 ,还可起自粘膜及间叶组织中残留的神经嵴细胞。Objective To investigate clinical manifestations and pathological features of primary malignant extra cutaneous and extra ocular melanoma.Methods Eighteen cases of primary malignant extra cutaneous and extra ocular melanoma were studied by pathohistology,electron microscope,and immunohistochemistry in which a panel of monoclonal antibodies against S 100 protein,HMB 45 and Vimentin were used and their clinical information was analyzed.Results The average age of patients was 51.6 years old and female was in the majority.Locally,5 cases were at rectum and canalis analis,4 cases at canitas nasi and antrum,2 cases at buccal mucous membrane,each one case at conjunctiva,urinary bladder,vagina,labium minus,cervix,bone and breast.Histologically,the shapes of tumor varied,it was like both carcinoma and sarcoma.Melanin granules appeared in 16 cases and non colored in 2 cases.Immunohistochemically,S -100 protein,HMB 45 and Vimentin antigen expressions were positive in tumor cells.Melanin bodies of different periods were shown in 6 cases by electron microscope.Conclusion Our study suggested that melanoma is derived not only from the cutaneous chromatophore,but also from the remaining neural crest cell of mucous membrane and mesenchymal tissue.

关 键 词：黑色素瘤 粘膜 免疫组织化学 皮肤肿瘤 病理 

分 类 号：R739.502[医药卫生—肿瘤]