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目的探讨肢端雀斑样黑色素瘤的病理形态学特征、组织发生、诊断及鉴别诊断、治疗及预后等。方法采用HE及免疫组化SP法对10例ALM进行染色,并复习相关文献。结果在水平生长期异形的黑色素细胞位于表皮基底层,进展期则浸润真皮深部。通常肿瘤细胞核大、可见核仁,染色质较粗,胞质嗜酸性,其内可见黑色素颗粒。免疫表型:HMB45、Melan-A、S-100、CK、Ki67均呈强阳性。结论 ALM主要见于无毛发被覆的肢端部位,如手掌、足底和甲下区,是黄种人与黑种人较常见的黑色素瘤类型。ALM确诊依靠病理检查。
Objective To investigate the pathomorphology, histogenesis, diagnosis, differential diagnosis, treatment and prognosis of acral freckle-like melanoma. Methods Ten cases of ALM were stained with hematoxylin and eosin (HE) and immunohistochemistry (SP), and the related literatures were reviewed. The results in the horizontal growth of abnormal shaped melanocytes located in the basal layer of the epidermis, advanced infiltration of deep dermis. Usually large tumor nuclei, visible nucleoli, chromatin thick, eosinophilic cytoplasm, which can be seen melanin particles. Immunophenotype: HMB45, Melan-A, S-100, CK, Ki67 were strongly positive. Conclusions ALM is mainly found in the non-hair-covered parts of the extremities, such as the palms, plantar and hypothyroid regions, and is a common type of melanoma in both yellow and black species. ALM diagnosis depends on the pathological examination.