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目的分析恶性黑色素瘤的病理特点。方法回顾性分析四川大学华西广安医院2005年7月—2015年1月收治的恶性黑色素瘤患者89例,结合病理特征、光镜检查、免疫组织化学及黑色素颗粒染色检测分析恶性黑色素瘤的病理特征。结果本组患者肿块体积在3.0 cm×2.1 cm×1.1 cm~1.1 cm×0.5 cm×0.4 cm,肿块颜色呈黑、褐、黑褐及暗红4种颜色。镜下可见肿瘤呈结节状、息肉状、菜花状、乳头状。肿瘤呈上皮样瘤细胞53例,占59.6%;肿瘤细胞呈棱形肿瘤细胞31例,占34.8%;混合型细胞5例,占5.6%。HE染色下,72例瘤组织结构、细胞形态、胞质内有明显黑色素颗粒,所有患者免疫组织化学HMB45与S-100均呈阳性。结论结合病理特征、光镜检查、免疫组织化学及黑色素颗粒染色检测可早期诊断恶性黑色素瘤。
Objective To analyze the pathological features of malignant melanoma. Methods A retrospective analysis of 89 patients with malignant melanoma admitted to Guangxi Guang’an Hospital from July 2005 to January 2015 was performed. The pathological features of malignant melanoma were analyzed by light microscopy, immunohistochemistry and melanin granulometry . Results The volume of lumps in this group was 3.0 cm × 2.1 cm × 1.1 cm ~ 1.1 cm × 0.5 cm × 0.4 cm. The color of the lumps was black, brown, dark brown and dark red. Microscope showed tumor nodular, polypoid, cauliflower, papillary. Tumor cells were epithelial tumor cells in 53 cases, accounting for 59.6%; tumor cells were prismatic tumor cells in 31 cases, accounting for 34.8%; mixed cells in 5 cases, accounting for 5.6%. Under HE staining, 72 cases of tumor tissue, cell morphology, obvious melanin granules in the cytoplasm, all patients immunohistochemistry HMB45 and S-100 were positive. Conclusion Combined with pathological features, light microscopy, immunohistochemistry and detection of melanin particles can be an early diagnosis of malignant melanoma.