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目的 探讨卵巢原发性恶性黑色素瘤的临床病理特征 ,及其与卵巢转移性肿瘤的鉴别诊断。方法 对 1例原发于卵巢囊性畸胎瘤的恶性黑色素瘤标本 ,通过光镜及免疫组化等方法进行病理组织学观察。结果 组织学特征为 :肿瘤细胞大小不等 ,形态多样 ,界限不清 ,呈透明细胞和 /或印戒细胞样 ;瘤细胞内外可见一些粗大的黑色素颗粒 ,瘤组织内血管较多 ,核分裂象多见 ,>10个 / 10HPF。免疫组化HMB45、Vimentin及S 10 0蛋白肿瘤细胞呈阳性表达。结论 卵巢原发性恶性黑色素瘤来源于卵巢成熟的囊性畸胎瘤恶变 ,是一种罕见的卵巢肿瘤。根据其组织学和病理形态学特征 ,结合腹部包块和囊性畸胎瘤等临床表现 ,可以作出明确的病理诊断。
Objective To investigate the clinicopathological features of ovarian primary malignant melanoma and its differential diagnosis with ovarian metastatic tumors. Methods One case of malignant melanoma, which originated from ovarian cystic teratoma, was observed histopathologically by light microscopy and immunohistochemistry. Results The histological features were as follows: tumor cells of various sizes, various shapes, unclear boundaries, were clear cells and / or signet ring cells; some thick melanin granules were seen both inside and outside the tumor cells, there were more blood vessels and more mitoses in tumor tissues See,> 10 / 10HPF. Immunohistochemistry HMB45, Vimentin and S 10 0 protein tumor cells were positive. Conclusions Ovarian primary malignant melanoma is a rare ovarian neoplasm derived from malignant cystic teratoma in ovary. According to its histological and pathological features, combined with abdominal mass and cystic teratoma and other clinical manifestations, can make a clear pathological diagnosis.