胆囊原发性恶性黑色素瘤1例及文献复习.pdfVIP

维普资讯 临床与实验病理学杂志 JClinExpPathol 2005Aug；20(4) ·465 · 胆囊原发性恶性黑色素瘤 l例及文献复习 胡小安，戴瑜珍，喻朝霞，潘陶强，卢 静，张 润 [摘要] 目的 探讨胆囊原发性恶性黑色素瘤的临床病理特征、组织发生及鉴别诊断。方法 对 1例原发于胆囊的恶性黑 色素瘤进行光镜观察，并行组织化学及免疫组化染色标记。结果 组织学特征为：在上皮和固有层交界处黑色素肿瘤细胞呈 巢状或片状分布，肿瘤细胞大小不等，形态多样。瘤细胞内外可见粗大的黑色素颗粒，Masson—Fontana染色阳性，免疫表型 HMB45、vimentin及S-100蛋白肿瘤细胞呈阳性表达。结论 胆囊原发性恶性黑色素瘤罕见，诊断必须结合病史 、全身检查及 随访资料，以排除转移性恶性黑色素瘤。 [关键词] 胆囊肿瘤；恶性黑色素瘤 ；免疫组织化学；诊断，鉴别 [中图分类号] R7358 [文献标识码] A [文章编号] 1001—7399(2005)04—4065—40 Primarymalignantmelanomaofgallbladder：acasereportandreview ofliterature HUXiao—an，DAIYu—zhen，YU Zhao—xia，PANTao—qiang，LUJing，ZHANGRun (DepartmentofPathology，AnqingF ￡People’SHospitalofAnhuiProvince，Anqing 246003。China) [Abstract] Purpose Tostudytheclinicopath0loca1featureandhistogenesisofprimarymelanomaofthegallbladdernaditsdiffer— ential diagnosis．M ethods A caseofprimarymalingantmelanomaarisingfrom thegallbladderwasstudiedhistopathologcallywithHE staining，histochemicalandimmunohistochemicaltechniques Results Thehistological characteristicsofthetumorwerethatthesheets nadnestsofmelnaomacellswereshowedatthejunctionoftheepitheliumnadlaminapropria．Thetumorcellsvariedinsizenadshape ． SomethickmelaningrainsthatstainedasmelaninpigmentwithFontana—Massonwereseeninoroutofthecells．Immunohistochemical stainsofHMB45，vimentinandS-100proteinwerepositiveinthetumorcells Conclusions Primarymalignnatmelanomaofhtegall— bladderisextremelyrale．Itisdifficulttodistinguishprimaryrfom mestastaticlesionsbasedonthehistopathologyalone Diagnosisof primarymelanomaCna bemadewithcombinationofpatient’Shistory，throughphysicexaminationnadfollow—updataaftermestastatic lesionsareexcluded [Keywords] gallbladderneoplasms；malignantmelanoma；immunohistochemistry；diagnosis，differential 胆囊原发性恶性黑色素瘤十分罕见，自1907年 急慢性胆囊炎、胆囊息肉或胆结石，术前难 以确诊。 Wieting报道首例 以来，至