摘要
目的 :研究皮肤恶性黑色素瘤(简称恶黑)的临床病理特点及免疫组化染色在恶黑诊断中的作用。方法 :对68例皮肤恶黑的临床及病理资料进行回顾性研究 ,其中32例用免疫组化SP法作Keratin、Vimentin、S 100、HMB 45等染色。结果 :皮肤原发性恶黑16.18%有明确的外伤史 ,25 %有色素痣史。临床初诊恶黑32例 ,误诊为其它病变的36例。上皮样细胞为主型32例 ,梭型细胞为主型25例 ,痣细胞样细胞为主型9例 ,气球样透明细胞为主型2例。经免疫组化染色 ,32例恶黑Keratin均为阴性 ,Vimentin、S 100均为阳性 ;HMB 45阳性29例(90.63%) ,阴性3例。结论 :皮肤恶黑的发生与色素痣及外伤有关 ,足底恶黑因其部位隐蔽 ,临床极易误诊。恶黑的细胞形态多样 ,组织结构复杂 ,Keratin、Vimentin、S 100、HMB 45等染色的联合应用及电镜观察有助于恶黑的诊断。
Objective:To study clinicopathologcal features of cutaneous malignant melanomas and the role of immunohistochemical stain in diagnosis.Method:Retrospective clinicopathological materials of 68 cases of cutaneous malignant melanomas were studied.Expressions of Keratin,Vimentin,S-100,HMB-45 were detected by immunohistochemistry SP method in 32 cases of cutaneous malignant melanomas.Result:11 of 68(16.18%) cutaneous malignant melanomas developed in sites which had been injured,17 of 68(25%) melanomas occured in previous melanocytic nevi.Of the 68 melanomas there were 32 with essential epitheliod cells,25 with mainly spindle cells,9 with nevus cells,2 with balloon clear cells.All 32 cases of melanomas in skin were negative to Keratin,but positive to Vimentin and S-100.29 of 32 (90.63%) melanomas were positive to HMB-45 and the other 3 were negative.Conclusion:Cutaneous malignant melanomas may result from injury and melanocytic nevi.Malignant melanoma of foot was easily misdiagnosed because of its shelter.Because the morphology and histology of cutaneous malignant melanomas were very complex,immunohistochemical stains(Keratin,Vimentin,S-100,HMB-45) and eletronmicroscopic detection were helpful for diagnosis of malignant melanoma.
出处
《四川肿瘤防治》
2000年第3期152-154,共3页
Sichuan Journal of Cancer Control
关键词
皮肤恶性黑色素瘤
病理
免疫组化
Cutaneous malignant melanoma
Clinicopathology
Immunohistochemistry
