皮肤黑素细胞病变的临床病理分析

doi:10.16150/j.1671-2870.2018.05.016

摘要/Abstract

摘要： 目的：探讨良、恶性皮肤黑素细胞病变的临床病理特征和鉴别诊断方法。方法：分析1例细胞型蓝痣、1例先天性痣伴非典型增生以及1例恶性雀斑样黑素瘤患者的临床表现、病理形态学及免疫表型特征。结果：3例患者均有不同大小的皮损,光学显微镜下观察其均表现为黑素细胞增生,且黑素细胞的形态、分化程度及生长方式表现多样化,存在交叉;免疫组织化学检测显示,3例患者病理组织中增生细胞可溶蛋白-100（soluble protein-100,S-100）蛋白、人黑素相关抗体（human melanoma-related antibody 45,HMB45）均呈阳性表达。结论：皮肤黑素细胞病变的病理类型多样,形态学及免疫表型具有不同程度的相似性,鉴别其良、恶性十分困难。应结合患者的临床特点及病理组织的大体观察特征、镜下所见、免疫表型特点,必要时辅以分子检测,以作出正确诊断。

关键词: 皮肤, 黑素细胞病变, 病理检查, 鉴别诊断

Abstract: Objective: To explore the clinicopathologic features and differential diagnosis of cutaneous melanocyte lesions. Methods: The clinical manifestation, morphology and immunophenotypic characteristics of 1 case of blue nevus, 1 case of borderline nevus and 1 case of malignant lentigo maliana melanoma were analyzed. Results: The 3 cases had lesions located in skin with different sizes, showing melanin cell hyperplasia, with various growth pattern and degree of differentiation and overlapping in existing. Immunohistochemical tests showed that the proliferated cells in all 3 cases had positive expressions of S-100 protein and HMB45. Conclusions: Various pathological types of melanocyte lesions are seen. Histopathology and immunohistochemistry showed different degrees of similarity, and the differentiation of benign and malignant lesions was very difficult. Clinicians should consider comprehensively the clinical characteristics, gross features, microscopic findings, immune phenotype and supplemented by molecular detection if necessary to make an accurate diagnosis.

Key words: Skin, Melanocytic lesions, Pathological examination, Differential diagnosis

中图分类号:

R733.2

杨茹雪, 李楠, 周婷, 赵艳, 陈少华, 朱清, 冯振中. 皮肤黑素细胞病变的临床病理分析[J]. 诊断学理论与实践, 2018, 17(05): 566-571.

YANG Ruxue, LI Nan, ZHOU Ting, ZHAO Yan, CHEN Shaohua, ZHU Qing, FENG Zhenzhong. Clinicopathologic analysis of skin melanocyte lesions[J]. Journal of Diagnostics Concepts & Practice, 2018, 17(05): 566-571.

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