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恶性黑色素瘤约占恶性肿瘤的1％,好发生30岁以上。可由正常皮肤、雀斑或痣的黑母细胞发生。好发部位为足部、手部和其它部位的皮肤。转移早、通过淋巴管到局部淋巴结;由血行转移到肺、脑、骨骼等处。预后不良。本文报道1例为右下肢皮肤恶性黑色素瘤纵隔转移误诊为右纵隔型大细胞肺癌的经过。 患者李××,男性,57岁,因进食不顺、发噎、胸部刺痛3个月来我院就诊,经胸透发现右上纵隔增宽并可见外突分叶状肿物,食管钡餐检查见食管受压移位、无粘膜破坏征象,拟诊为纵隔恶性淋巴瘤收入院。T、P、R、Bp均正常。一般情况好、发育正常、营养佳、自动体位,全身浅部淋巴结无肿大。头颈部无异常,胸部对称、肋骨走行均匀、双肺呼吸音正常、心脏无杂音、心律齐、心率90次/分。腹部无肿块、肝脾未触及、四肢脊柱无畸型。
Malignant melanoma accounts for about 1% of malignant tumors, and is well over 30 years old. May occur from normal blasts, freckles, or nevus black mother cells. The predilection sites are the skin of the feet, hands, and other parts. Transfer early, through the lymphatics to regional lymph nodes; from the blood to the lungs, brain, bones, etc. Poor prognosis. This article reports one case of mediastinal metastasis of the right lower extremity malignant melanoma misdiagnosed as right mediastinal type large cell lung cancer. Patient Li X, male, 57 years old, presented to our hospital due to poor feeding, cyanosis, and chest tingling for 3 months. After chest thorax, the right upper mediastinum was widened and the outer lobular mass was visible. The esophageal barium meal examination was performed. See esophageal pressure displacement, no signs of mucosal destruction, was diagnosed as a hospital for mediastinal malignant lymphoma. T, P, R, Bp are normal. The general situation is good, normal development, good nutrition, automatic position, no enlargement of the superficial lymph nodes. There were no abnormalities in the head and neck, chest symmetry, uniform rib walks, normal lung breath sounds, no heart murmur, heart rhythm, and heart rate of 90 beats/min. There was no lumps in the abdomen, no contact between the liver and spleen, and no deformity of the limbs and spine.