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目的探讨腋窝转移性恶性黑色素瘤(malignant melanoma,MM)的临床病理学特点,以减少误诊误治。方法回顾性分析7例腋窝转移性MM的临床及病理资料。结果 7例平均年龄为60.1岁,均因腋下肿物就诊,仅两例术前确诊,5例误诊为恶性淋巴瘤、梭形细胞肉瘤、恶性外周神经鞘膜瘤、肺癌、神经纤维肉瘤,均经追问病史和单纯根治性手术后病理免疫组化确诊,S-100均阳性,两例HMB-45阳性。术后3例失访,1例死亡。结论腋窝转移性MM临床表现无特异性,肿瘤细胞形态复杂多样,极易误诊,病理和临床医师在诊断时应想到该病的可能,需仔细询问病史和细致行体格检查,病理诊断应结合免疫组化、特殊染色或电镜检查。
Objective To investigate the clinicopathological features of malignant melanoma (MM) in axillary metastases to reduce misdiagnosis and mistreatment. Methods Retrospective analysis of 7 cases of axillary metastatic MM clinical and pathological data. Results The average age of 7 cases was 60.1 years old. All were treated with axillary tumors. Only two cases were diagnosed preoperatively. Five cases were misdiagnosed as malignant lymphoma, spindle cell sarcoma, malignant peripheral nerve sheath tumor, lung cancer, neurofibrosarcoma, All cases were confirmed by histopathology and immunohistochemistry after radical surgery. S-100 was positive and two cases of HMB-45 were positive. Three patients were lost to follow-up and one died. Conclusion Clinical manifestations of axillary metastasis MM non-specific, complex and diverse tumor cell morphology, easily misdiagnosed, pathology and clinicians should be diagnosed with the disease should be considered, careful examination of medical history and meticulous physical examination, pathological diagnosis should be combined with immunity Tissue, special staining or electron microscopy.