基础医学与临床 ›› 2015, Vol. 35 ›› Issue (9): 1252-1255.

• 临床园地 • 上一篇    下一篇

肛管直肠恶性黑色素瘤7例临床病理学分析

李钢琴1,袁修学2,夏小丽1,龚立刚1,袁静萍3   

  1. 1. 武汉市第八医院
    2. 武汉科技大学医学院 基础医学院
    3. 武汉市中心医院
  • 收稿日期:2015-06-03 修回日期:2015-07-08 出版日期:2015-09-05 发布日期:2015-09-07
  • 通讯作者: 袁修学 E-mail:exiu2001@sohu.com
  • 基金资助:
    湖北省自然科学基金;武汉市卫生局立项课题

Anorectal malignant melanoma:a clinicopathological analysis of seven cases

  • Received:2015-06-03 Revised:2015-07-08 Online:2015-09-05 Published:2015-09-07
  • Contact: YUAN Xiuxue E-mail:exiu2001@sohu.com

摘要: 目的 探讨肛管直肠恶性黑色素瘤的临床病理特征。方法 收集7例肛管直肠恶性黑色素瘤的临床病理资料并随访,分析其临床和病理组织学特征和免疫表型。结果 本例中包含女性5例,男性2例,年龄50-68岁,平均61岁。肿瘤位于直肠下端1 例,齿线附近2例,肛管肛缘4例。该肿瘤组织结构和细胞形态有多样性。组织结构上主要为弥漫片状、巢状,腺泡状。细胞形态主要为上皮样、梭型细胞样、淋巴细胞样。免疫组织化学检测显示肿瘤细胞HMB45、S-100和vimentin 强阳性,LCA、CK和EMA均阴性,其中2例CEA灶性阳性,Ki-67 LI为20%~50%。结论 肛管直肠恶性黑色素瘤是少见的恶性肿瘤,其特征性的组织形态、免疫表型有助于诊断和鉴别诊断。

关键词: 恶性黑色素瘤,肛管直肠, 临床病理特征, 免疫组化, 鉴别诊断

Abstract: Objective To investigate the clinical and pathological features of anorectal malignant melanoma(AMM). Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected. The clinical and histopathological features and immunophenotype was analyzed. Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years. The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line, 4 cases of anal anus. The structure and morphology of the cancer cells were diverse. The organizational structure were mainly diffuse, focal and acinar. The cellular morphology were mainly epithelioid, spindle and lymphocyte like. And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells. However, the expression of CK, EMA and LCA were negative. And 2 cases of CEA expression were positive, LI Ki-67 was 20~50%. Conclusion Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology, immunophenotype could be helpful for diagnosis and differential diagnosis.

Key words: Anorectal malignant melanoma, Clinicopathologic features , Immunohistochemistry, Differential diagnosis

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