肺转移性恶性黑色素瘤误诊为透明细胞瘤的分析  

Analysis of the misdiagnosis pulmonary metastatic malignant melanoma as clear cell tumor

作　　者：周璇[1] 李孜孜[1] 苟新敏[1] 

机构地区：[1]珠海市中山大学附属第五医院病理科,519000

出　　处：《中国实用医药》2014年第29期62-63,共2页China Practical Medicine

摘　　要：目的探讨肺转移性恶性黑色素瘤误诊的原因。方法对1例肺转移性恶性黑色素瘤误诊为肺透明细胞瘤作回顾性分析。结果肿瘤细胞呈巢状分布,胞浆透明或粉染,间质有薄壁的窦状血管,免疫组化染色结果显示:瘤细胞S-100、HMB45、Melan-A均阳性,与肺透明细胞瘤的组织学改变及免疫组化表型极为相似。由于患者曾有皮肤背部色素痣的切除史,且现发现原皮肤活检处存在肿瘤原发灶,应诊断为肺转移性恶性黑色素瘤。结论恶性黑色素瘤的临床特点多样,组织学形态复杂,诊断时应仔细观察病理切片,同时详细了解临床病史,并结合临床相关辅助检查,以减少误诊。Objective To investigate the reason of pulmonary metastatic malignant melanoma misdiagnosed as clear cell tumor. Methods A retrospective analysis was made on 1 case of pulmonary metastatic malignant melanoma misdiagnosed as clear cell tumor. Results Tumor cells were in nests distribution, the cytoplasm was clear or pink dyed, and mesenchyme contained thin-walled sinus veins. Immunohistocbemical staining Results showed that tumor cells S-100, HMB45, and Melan-A were all positive, and they were similar with the histologic and immunohistochemical phenotypes of pulmonary clear cell tumor. Due to the previous skin pigment nevus resection on the back of the patient and primary tumor found in the same place, this patient should be diagnosed as pulmonary metastatic malignant melanoma. Conclusion The clinical features of malignant melanoma are various and have complicated histological appearance. Pathological section should be carefully observed and clinical history of patients must be known before diagnosis. A combination with clinical related auxiliary examination is helpful for reducing misdiagnosis.

关 键 词：肺转移性 恶性黑色素瘤 透明细胞瘤 误诊 

分 类 号：R734.2[医药卫生—肿瘤]