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目的探讨淋巴结痣(NN)的临床病理学特征及鉴别诊断要点。方法对3例NN进行组织学及免疫组化分析,并复习相关文献。结果 3例中2例为女性,年龄分别为61岁和44岁,均伴乳腺癌,分别在腋窝淋巴结实质、被膜发现痣细胞;另1例为27岁男性,颈部淋巴结被膜及输入淋巴管周围见痣细胞。组织学均与皮肤皮内痣细胞相似,无核多形性和核分裂,胞质内见黑色素。免疫组化3例均为melan A和S-100(+),cytokeratin-pan(-),Ki-67(-)或<1%阳性;2例HMB45(-),1例HMB45(+),2例p16(+)。术后随访9~13个月,3例均无复发及转移。结论 NN是少见的良性病变,根据组织病理学及免疫组化特征可确诊,临床中应与淋巴结转移性恶性黑色素瘤及转移癌相鉴别。
Objective To investigate the clinical pathological features and differential diagnosis of lymph node nevi (NN). Methods Three cases of NN were histologically and immunohistochemically analyzed and relevant literature reviewed. Results Two of the three patients were female, aged 61 and 44 years old, all with breast cancer. Nevus cells were found in the parenchyma and capsule of the axillary lymph nodes. The other case was a 27-year-old male with cervical lymph node capsule and lymphatic input See nevus cells around. Histology are similar to the skin intradermal nevus cells, non-nuclear pleomorphism and nuclear fission, melanin in the cytoplasm. Three cases of immunohistochemistry were melan A and S-100 (+), cytokeratin-pan (-), Ki-67 2 cases of p16 (+). All cases were followed up for 9 to 13 months. No recurrence and metastasis occurred in the three cases. Conclusion NN is a rare benign disease. According to histopathology and immunohistochemical characteristics, NN can be diagnosed clinically and should be differentiated from lymph node metastatic malignant melanoma and metastatic carcinoma.