目的探讨促纤维增生性恶性黑色素瘤(DM)的临床病理特征及鉴别诊断要点。方法对5例DM进行临床分析及光镜和免疫组化标记观察。结果 5例DM中,男性2例,女性3例,年龄52~72岁,平均年龄62.6岁。肿瘤位于躯干1例,四肢4例。组织学特点:肿瘤性梭形细胞位于成熟的胶原纤维束内或之间,梭形肿瘤细胞排列混乱;3例部分肿瘤细胞胞质内可见黑色素,表皮上可见非典型交界性病变;5例均在肿瘤内或肿瘤边缘可见淋巴细胞、浆细胞浸润,并表现为亲神经性。免疫组化示肿瘤细胞S-100蛋白弥漫强(+),HMB45和melan-A(-)。结论促纤维增生性恶性黑色素瘤是一种罕见肿瘤,易与其他梭形细胞肿瘤混淆,免疫组织化学染色有助于诊断与鉴别诊断。 Objective To investigate the clinicopathological features and differential diagnosis of fibromic hyperplastic malignant melanoma (DM). Methods Clinical analysis of 5 cases of DM and light microscopy and immunohistochemical markers. Results In 5 DM cases, there were 2 males and 3 females, ranging in age from 52 to 72 years with a mean age of 62.6 years. Tumor in the trunk in 1 case, limbs in 4 cases. Histological features: tumorous spindle cells located in or within the mature collagen fiber bundles, spindle-shaped tumor cells arranged in disorder; 3 cases of tumor cells in the cytoplasm of melanin visible on the surface of atypical borderline lesions; 5 cases were In the tumor or tumor margins visible lymphocytes, plasma cell infiltration, and showed a neurotic. Immunohistochemistry showed that the tumor cells S-100 protein diffuse strong (+), HMB45 and melan-A (-). Conclusions Fibroblastic malignant melanoma is a rare tumor that is easily confused with other spindle cell tumors. Immunohistochemical staining is helpful for the diagnosis and differential diagnosis.