摘要
目的观察食管原发性恶性黑色素瘤（primary malignant melanoma of esophagus，PMME）的影像学、病理组织学和免疫表型特征，探讨其临床病理学特征、诊断、鉴别诊断及治疗。方法对5例PMME行HE及免疫组化染色，并结合相关文献对其临床表现、影像学、组织学形态、免疫表型、治疗和预后进行观察分析。结果5例患者均为老年男性，平均年龄63．4岁，临床均表现为进食不畅，症状呈进行性加重。肿瘤细胞呈巢片状或条索状排列，细胞圆形或多角形，胞质丰富红染，胞质内见黑色素颗粒，细胞核大小不一，核居中或偏位，核仁明显，病理性核分裂象易见。免疫表型：瘤细胞弥漫表达HMB-45、Melan-A、S-00，CK阴性，Ki-67增殖指数40％～45％。结论PMME非常罕见，恶性程度高，预后差。免疫组化染色有助于其诊断，需与低分化癌、食管癌肉瘤、食管淋巴瘤、神经内分泌癌、食管平滑肌瘤等进行鉴别。
Purpose To investigate the clinicopathologic characteristics, diagnosis, differential diagnosis and treatment of primary ma- lignant melanoma of esophagus （PMME）. Methods Using light microscopy and immunohistochemistry, we studied 5 cases of PMME, reviewed relevant literature and analyzed the clinical manifestations, radiographic, histological, immunohistochemical charac- teristics, treatment and prognosis of the tumor. Results The 5 male patients, at the mean age of 63.4 years, all presented dysphagia and the symptoms were progressively aggravated. Histopathologically, the tumor cells were arranged in nests or cords and/or flake structures, round or polygonal in shape, with abundant pink cytoplasm, and melanin granules were visible within the cytoplasm. The nucleus varied in size, centrally or eccentrically located, with prominent nucleoli, and frequent pathological mitosis. Immunohisto- chemical staining showed that the tumor cells were positive for HMB-45, Melan-A, S-100, but negative for CK. Ki-67 index was 40% - 45%. Conclusions Primary malignant melanoma of the esophagus is very rare and highly malignant, with poor prognosis. Immuno- histochemical staining helps its diagnosis and differential diagnosis from other tumors including poorly-differentiated cancer, carcinosa- rooma, esophageal lymphoma, neuroendocrine carcinoma and leiomyoma of the esophagus.
出处
《临床与实验病理学杂志》
CAS
CSCD
北大核心
2014年第10期1090-1093,共4页
Chinese Journal of Clinical and Experimental Pathology
关键词
食管肿瘤
恶性黑色素瘤
免疫组织化学
鉴别诊断
esophagus neoplasms
malignant melanoma
immunohistochemistry
differential diagnosis
