原发性子宫颈恶性黑色素瘤1例并文献复习  

Primary malignant melanoma of cervix:a case report and literature review

作　　者：王洁爽 李瑞[2] 陈宏伟[2] 刘钰晨[1] 计金双 敖启林[3] 黄磊[2] Wang Jieshuang;Li Rui;Chen Hongwei;Liu Yuchen;Ji Jinshuang;Ao Qilin;Huang Lei(Department of Obstetrics&Gynecology,Jianghan Medical School,Jianghan University,Wuhan 430056,China;Department of Obstetrics&Gynecology,The Central Hospital of Wuhan,Wuhan 430014,China;Institute of Pathology,Tongji Hospital and Department of Pathology,Tongji Medical College,Huazhong University of Science and Technology,Wuhan 430030,China)

机构地区：[1]江汉大学医学院妇产科,武汉430056 [2]武汉市中心医院妇科,武汉430014 [3]华中科技大学同济医学院附属同济医院病理研究所,同济医学院病理学系,武汉430030

出　　处：《中国组织化学与细胞化学杂志》2023年第2期176-181,共6页Chinese Journal of Histochemistry and Cytochemistry

基　　金：武汉市中心医院年度学科基金项目(2021XK 079,2021XK078);江汉大学科研创新基金项目(201240003107)。

摘　　要：目的探讨1例原发性子宫颈恶性黑色素瘤(primary malignant melanoma of the cervix,PMMC)的临床病理学特征、鉴别诊断、治疗及预后。方法应用HE染色、免疫组织化学染色对武汉市中心医院收治的1例PMMC的临床病理特点及免疫表型进行分析,并进行相关的国内外文献复习。结果大体标本呈乳头状,色暗红,局灶灰黑,大小4 cm×4 cm;镜下见不规则巢团样排列的肿瘤细胞弥漫浸润子宫颈壁,肿瘤细胞主呈上皮样,胞质较丰富,核多形较明显,少数细胞可见清晰核仁,未见明显色素颗粒;免疫组织化学表型:S-100、SOX-10、melan-A、MiTF弥漫强阳性,p16、vimentin阳性,CD34、D2-40示脉管,Ki-67增殖指数约50%,HMB-45、PCK、p40阴性。结论PMMC是一种恶性程度极高、临床上罕见的肿瘤,术前诊断主要依赖临床表现、病理活检及免疫组织化学染色结果。手术治疗为主,术后结合辅助治疗,预后差。Objective To investigate the clinicopathological features,differential diagnosis,treatment and prognosis of a case of primary malignant melanoma of the cervix(PMMC).Methods HE staining and immunohistochemical staining were used to analyze the clinicopathological features and immunophenotype of a case of PMMC admitted to the Central Hospital of Wuhan,and the related literatures at home and abroad were reviewed.Results The gross specimen was papillary dark red,with a gray-black size of 4 cm×4 cm.Microscopically,The tumor cells arranged in irregular nests infiltrated the cervical wall diffusely.The tumor cells were mainly epithelioid with abundant cytoplasm and obvious nuclear polymorphism.A few cells showed clear nucleolus and no obvious pigment granules.Immunohistochemical phenotype:S-100,SOX-10,melan-A,MiTF were diffuse strong positive,P16,vimentin were positive,CD34,D2-40 were vascular,the proliferation index of Ki-67 was 50%,and HMB-45,PCK,P40 were negative.Conclusion PMMC is a rare tumor with high malignancy.Preoperative diagnosis depends mainly on clinical manifestations,pathological biopsy and immunohistochemical staining.The prognosis of surgical treatment combined with adjuvant treatment is poor.

关 键 词：恶性黑色素瘤 宫颈 免疫组织化学表型 鉴别诊断 

分 类 号：R365[医药卫生—病理学]