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患者女,60岁。头面、躯干、四肢大小不等黑红色结节,无痛痒3年,半年内泛发全身。皮肤科情况:头面、躯干、四肢见大小不等高粱粒至黄豆大小结节,呈皮色、暗红色及黑色。左膝关节上方见一直径约2cm×2cm大小肿块,其上见4～5个大小不等皮色至黑色结节,部分结节表面结痂。皮损组织病理示:真皮内弥漫性肿瘤样细胞浸润,此肿瘤样细胞核大、核仁明显,部分肿瘤样细胞呈巢状排列,肿瘤组织内见坏死。免疫组织化学染色显示肿瘤细胞LCA(-),CK20(-),S100蛋白及HMB45弥漫强阳性,Vimentin弥漫阳性。诊断:黑素瘤。
Female patient, 60 years old. Head and face, trunk, limbs ranging from black and red nodules, itching 3 years, generalized within six months of the body. Dermatology: Head, trunk, limbs, see the size ranging from sorghum grain to soybean size nodules, was skin color, dark red and black. Above the left knee joint see a diameter of about 2cm × 2cm size of the tumor, which see 4 to 5 skin color ranging from black to nodules, some nodular surface scab. Pathological lesions showed: Diffuse diffuse tumor-like cells within the dermis, the tumor-like nuclei, significant nucleoli, some tumor-like cells arranged in nests, necrosis of the tumor tissue. Immunohistochemical staining showed that the tumor cells LCA (-), CK20 (-), S100 protein and HMB45 diffuse strong positive, Vimentin diffuse positive. Diagnosis: Melanoma.