腮腺原发性恶性黑色素瘤临床病理观察.docVIP

腮腺原发性恶性黑色素瘤临床病理观察【摘要】 目的观察原发性恶性黑色素瘤的病理形态。方法 标本采用组织病理学和免疫组化(S-100、HMB-45、Male-A)进行观察。结果 肿瘤组织位于腮腺一侧,瘤组织呈推挤性边缘浸润至腮腺组织中,瘤细胞分布弥散,有窦样血管及少许纤维间质分隔,瘤细胞有异型性,核异型明显,边缘区个别肿瘤细胞细胞质内及肿瘤间质内有棕黄褐色素颗粒。免疫组化:瘤细胞S-100、HMB-45及Male-A强阳性; NSE、Vimentin弱阳性;LCA、CD15、CD30、Cytokeratin、EMA、Desmin、SMA、PLAP、Synapsin及Chromogranin A均为阴性。结论 腮腺原发性恶性黑色素瘤极为罕见,组织起源尚有争议,可能起源腮腺导管甚或腺泡中DOPA阳性细胞。 【关键词】 腮腺;黑色素瘤;临床病理 Clinical pathology observe of primary m alignant melanoma of parotid gland LIN Yu-jing, KONG Mei, WANGXiao-hong,et al. Department of Pathology,The fifth affiliated hospital of Sun Yat-Sen University,Guangdong,Zhuhai 519000,China 【Abstract】 Objective To observe the clinical pathology form of primary m alignant melanoma.Methods Specimens were observed by histopathology and immunohistopathologic (S-100,HMB-45,Male-A).Results Tumor is located on the side,and infiltration of radiofrequent pushed its way to the edge of the Parotid gland tissue.the distribution of dispersoids tumor cells,there were sinusal-like vessel and a little fiber interstitialoma separated,tumor cells have multiformity,nuclear heterotype obvious,fringe cytoplasmic individual tumor cells and the tumor interstitialoma capsulelike brown yellow-brown pigment particles.Immunohistochemistry:The tumor cells were positive for S-100,HMB-45 and Amale-A,weak positive for NSE,Vimentin,but negative for LCA,CD15,CD30,Cytokeratin,EMA,Desmin,SMA,PLAP,Synapsin andChromogranin A.Conclusion Primary m alignant melanoma of the Parotid gland is extremely rare,its histogenesis was disputed,may be the origin of the parotid duct or even DOPA-positive cells in aciner. 【Key words】 Parotid gland;M alignant melanoma;Clinical pathology 恶性黑色素瘤(m alignama melanoma,简称恶黑,MM)占全身恶性肿瘤15%,20%的MM来源于头颈部。MM很少侵犯腮腺,原发于腮腺的MM非常罕见,近年国内文献仅有报道的腮腺原发MM 3.1 诊断标准 Woodward建议腮腺原发性恶黑的诊断标准为: ①肿瘤位于腮腺内; ②肿块内没有确定的淋巴结; ③在仔细查找眼、皮肤、鼻腔、咽喉、口腔、食管、生殖器区域和脑膜后未发现有恶黑; ④先前没有恶黑切除史或色素损伤。本例完全符合以上诊断标准。 腮腺区恶性黑色素瘤本来发病率极低,有学者报道19年12例腮腺区MM,仅有一例未找到原发灶[5]。Wang等认为未发现腮腺外原发灶的腮腺恶黑