实用肿瘤学杂志 ›› 2008, Vol. 22 ›› Issue (6): 506-508.

• 论 著 • 上一篇    下一篇

10例肛管直肠恶性黑色素瘤临床病理免疫组化研究

刘红胜1, 章美珍1, 徐锦屏1, 金利刚2   

  1. 1.杭州市萧山区第一人民医院病理科(杭州 311200);
    2.杭州市公安局萧山区分局刑侦大队
  • 收稿日期:2007-12-18 出版日期:2008-12-20 发布日期:2012-02-21
  • 作者简介:刘红胜, 女, (1975-), 本科, 医师, 从事消化道肿瘤的治疗

Clinical pathology and immunohistochemistry study in 10 cases of anorectal malignant melanoma

LIU Hongsheng, ZHANG Meizhen, XU Jinping, JIN Ligang   

  1. Department of Pathology, The First People′s Hospital, Xiaoshan 311200
  • Received:2007-12-18 Online:2008-12-20 Published:2012-02-21

摘要: 目的研究肛管直肠恶性黑色素瘤(简称恶黑)的临床病理特点及免疫组化染色在恶黑诊断中的作用。方法 对肛管直肠恶黑的临床资料进行回顾性分析, 用免疫组化S-P法作HMB45、S-100、Vimetin等染色。结果 10例肛管直肠恶黑临床初步诊断恶黑1例, 误诊其它疾病9例。病理形态:上皮样细胞为主7例, 梭形细胞为主2例, 小细胞似淋巴细胞样细胞为主1例。免疫组化染色:10例HMB-45、S-100均阳性, 9例Vimetin阳性, 其中1例CK阳性, LCA阴性。结论 肛管直肠恶黑临床表现大便带鲜血, 无明显黏液, 肛门异物及息肉样突出肛门为特征, 临床极易误诊。形态观察支持恶黑起源于表皮基底层黑色素细胞, 免疫标记提示黑色素细胞起源于神经嵴。HMB45、S-100、Vimetin, 三者联合应用能提高恶黑病理诊断的准确性。

关键词: 黑色素瘤, 肛管直肠, 免疫组化, 临床病理

Abstract: Objective To study clinicopathological feature of anorectal malignant melanoma and the role of immunohistochemical stain in diagnosis.Method 10 cases of anorectal malignant malanoma were studied.Expression of HMB45, S-100, Vimetin were detected by immunohistochemistry with S-P method.Result 1 case is malignant melanoma.9 cases were misdiagnosed as other diseases.Clinicopathologic features:7 cases with essential epitheliod cell, 2 cases with mainly spindle cell, 1 case with small lymphocyte-like cell.All 10cases of anorectal malignant melanoma were positive to HMB45, S-100 and 9 cases were positive to vimetin and 1 case were positive to CK, but negative to LCA.Conclusion The faeces with fresh blood, no evident mucus.The masses were nodular, fungiform or ulcerative.Histopathologic observation supported the idea that this tumor developed from the melanocytes.10 cases at the basal-layer of the epithelium.Immunohistochemistry proved that melanocytes originated from the neural crest.Immunohistochemical stain HMB45, Vimetin S-100 were helpful for diagnosis of malignant melanoma.

Key words: Melanoma, Anarectum, Immunohistochemistry, Clinicopothology

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