目的对皮肤恶性黑色素瘤的临床病理特征和鉴别诊断进行讨论和研究。方法 80例皮肤恶性黑色素瘤患者作为研究对象,进行临床病理特征回顾性研究,分析诊断方法。结果 80例患者皮肤病变多呈现出褐色和棕色的无痛斑块,下肢以脚底和脚趾为主,同时部分患者出现了明显的瘙痒感,被抓破后易发生溃疡,且难以治愈。肿瘤体积中最小者为0.6 cm×0.6 cm×0.5 cm,最大者为7 cm×5 cm×2 cm,与周围组织的边界模糊不清,其中具有结节状瘤体者47例。皮肤恶性黑色素瘤的细胞形态十分多样化,主要有上皮样细胞、透明细胞、小痣样细胞和梭形细胞等形态。同时在其排列形态上也有着一定的特点,主要呈现束状、巢状、梁状、旋涡状和假腺泡状等。免疫化染色体显示瘤细胞S-100蛋白、HMB45、Vimentin阳性率分别为95%、93%、98%,同时SMA、LCA均呈现阴性。结论皮肤恶性黑色素瘤的组织和病理形态有着多样化的特点,在诊断的过程中主要依靠病理学和免疫组织化学进行判断,对此需要加以重视,从而更好的采取措施对患者实施治疗。 Objective To investigate the clinical and pathological features and differential diagnosis of malignant melanoma in skin. Methods Eighty patients with cutaneous malignant melanoma were studied retrospectively, and their diagnostic methods were analyzed retrospectively. Results The skin lesions of 80 patients showed mostly brown and brown painless plaques. The lower extremities mainly consisted of soles and toes, and some patients had obvious pruritus. After being scratched, ulcers easily appeared and were difficult to cure. The smallest tumor volume was 0.6 cm × 0.6 cm × 0.5 cm and the largest was 7 cm × 5 cm × 2 cm. The border of the tumor with the surrounding tissues was unclear, of which 47 had nodular tumors. Malignant melanoma of the skin cell morphology is very diverse, mainly epithelial cells, transparent cells, small nevus-like cells and spindle cells and other forms. At the same time in its arrangement of morphology also has certain characteristics, mainly presents bundles, nests, beams, whirlpool and pseudo-glandular bubble. Immunohistochemistry showed that the positive rates of S-100 protein, HMB45 and Vimentin in tumor cells were 95%, 93% and 98%, respectively. Meanwhile, the positive rates of SMA and LCA were all negative. Conclusion The histological and histopathological features of cutaneous malignant melanoma are diverse. Judging mainly by pathology and immunohistochemistry in the process of diagnosis, it is necessary to pay more attention to it and take better measures to treat the patients.