淋巴结痣3例临床病理观察  

Lymph node melanocytic nevi: a clinicopathologic study of three cases

作　　者：程琼琳 李霄[2] 宋国新[2] 范钦和[2] 张智弘[2] 朱岩[2] 

机构地区：[1]宁乡县人民医院病理科,湖南宁乡410600 [2]南京医科大学第一附属医院病理科,南京210029

出　　处：《诊断病理学杂志》2017年第1期26-29,33,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨淋巴结痣(NN)的临床病理学特征及鉴别诊断要点。方法对3例NN进行组织学及免疫组化分析,并复习相关文献。结果 3例中2例为女性,年龄分别为61岁和44岁,均伴乳腺癌,分别在腋窝淋巴结实质、被膜发现痣细胞;另1例为27岁男性,颈部淋巴结被膜及输入淋巴管周围见痣细胞。组织学均与皮肤皮内痣细胞相似,无核多形性和核分裂,胞质内见黑色素。免疫组化3例均为melan A和S-100(+),cytokeratin-pan(-),Ki-67(-)或<1%阳性;2例HMB45(-),1例HMB45(+),2例p16(+)。术后随访9~13个月,3例均无复发及转移。结论 NN是少见的良性病变,根据组织病理学及免疫组化特征可确诊,临床中应与淋巴结转移性恶性黑色素瘤及转移癌相鉴别。Purpose To investigate the clinicopathological characteristics and differential diagnosis of nodal nevi （NN）. Methods Three cases of NN were analyzed by light microscopy and immunohistochemical staining, and the relevant literatures were reviewed. Results Two of three patients were female concomitant with invasive breast cancer, the ages were 61 and 44 years, respectively, and aggregates of bland nevus cells were observed in the nodal parenehyma and the capsule. The other patient was 27-year-old male, and his cervical lymph node revealed nevus with involvement of both capsule and surrounding afferent lymphatic vessel. Microscopically, 3 cases of NN were similar to intradermal nevus. Nuclear pleomorphism and mitoses were abcent. These cells contained fine grained brown pigments. Immunohistochemical stains with S100 and MelanA were diffusely positive in all 3 cases, whereas eytokeratin-pan （ CKpan ） confirmed the absence of reactivity. Ki-67 was negative or only scattered positive nuclei （ 〈 1% ）. The HMB-45 immunohistochemical stain showed negative staining in 2 cases and positive in 1 case. p16 was positive in 2 cases. After 9 - 13 months of follow- up, all 3 cases had no recurrence and metastasis. Conclusions NN is a rare and benign disease, and it can be distinguished from metastatic melanoma and metastatic carcinoma by evaluation of histopathologic characteristics and the assistance of immunohistochemistry.

关 键 词：淋巴结痣 免疫组化 临床病理 

分 类 号：R736.4[医药卫生—肿瘤]