快速冰冻免疫组化染色诊断阴道恶性黑色素瘤1例及其的应用价值.docVIP

快速冰冻免疫组化染色诊断阴道恶性黑色素瘤1例及其的应用价值 　　摘要：阴道恶性黑色素瘤是一类非常罕见，但恶性程度高且复发率高的肿瘤，其发病率在全球范围内呈上升趋势，严重威胁了女性的生命健康。本文报道一例天津市中心妇产科医院快速冰冻切片免疫组化染色诊断阴道恶性黑色素瘤的病例。该患者为老年女性，19年前因子宫肌瘤行子宫全切术，现因阴道分泌物增多伴出血就诊，阴道镜检查发现宫颈黑色病变，TCT检测见部分含有黑色素的细胞，患者术中送检组织进行冰冻检测，但因送检组织小，不具备诊断恶性黑色素瘤的标准，遂行快速冰冻免疫组化染色HMB45和MelanA均呈阳性，冰冻诊断考虑为恶性黑色素瘤，石蜡切片HE及免疫组化染色支持阴道恶性黑色素瘤。通过报道该病例，探讨快速冰冻切片免疫组化染色的临床意义及应用价值。 　　关键词：恶性黑色素瘤，快速冰冻免疫组化，HMB45，MelanA 　　Diagnosis of Vaginal Malignant Melanoma by Rapid Frozen Immunohistochemical Staining：A Case Report and Its Application Value 　　SONG Jian-chan，SI Jing-wen，CHEN Ling，ZHANG Xin-ying，SHI Yi-quan，LIU Yi-xin 　　（Department of Pathology，Tianjin Central Hospital of Gynecology Obstetrics，Tianjin，300100，China） 　　Abstract：Vaginal malignant melanoma is a very rare，but high degree of malignancy and high recurrence of the tumor，the incidence rate in the global context is on the rise，a serious threat to womens life and health.This paper reports a case of Tianjin Central Obstetrics and Gynecology Hospital rapid frozen section immunohistochemistry staining in diagnosis of vaginal malignant melanoma cases.The patient was an old women，19 years ago due to uterine fibroids hysterectomy，due to increased vaginal secretions with hemorrhage treatment，cervical lesions found in black colposcopy and TCT detection showed some melanin containing cells.For patients with frozen tissue detection，but because the inspection organization is small，does not have the diagnosis of malignant melanoma of the standard，carry out the frozen immunohistochemistry staining of HMB45 and MelanA were positive，frozen for diagnosis of malignant melanoma，paraffin HE and immunohistochemical staining in support of malignant melanoma in the vagina.Through the case study reports，to investigate the clinical significance and application value of rapid frozen section immunohistochemical staining. 　　Key words：Malignant melanoma；Rapid frozen immunohistochemistry；HMB45；MelanA 　　1资料与方法 　　1.1病例 患者，女性，67岁，主因子宫肌瘤行子宫全切术后19年，阴道分泌物增多伴出血就诊于外院，诊断为阴道炎，为