摘要
目的:探讨食管原发性恶性黑色素瘤(primary malignant melanoma of the esophagus,PMME)的病理形态学特点、诊断、鉴别诊断和预后等。方法:观察和分析1例食管原发性恶性黑色素瘤的病理形态学特征,免疫表型,并进行文献复习。结果:食管原发性恶性黑色素瘤以进行性吞咽困难为主要症状。镜下肿瘤细胞排列呈弥漫片状或巢团状,可见多量黑色素沉积;瘤细胞体积较大,形态多样,卵圆形、梭形或多角形,胞质丰富红染,细胞核大,可见明显嗜酸性核仁,部分细胞核偏位,核分裂易见。周围鳞状上皮基底层及上皮间质交界处黑色素及吞噬色素的细胞明显增多,巢状或层状分布。肿瘤侵至黏膜下层,无淋巴结转移。免疫组化弥漫表达Vimentin、HMB45及S100,而CKpan等上皮标记阴性。结论:食管原发性恶性黑色素瘤是一种罕见的食管恶性肿瘤。恶性程度高,预后差。免疫组化有助于其诊断,需要与低分化鳞状细胞癌等其它食管恶性肿瘤相鉴别。
Objective:To study the histopathological features,diagnosis,differential diagnosis and prognosis of primary malignant melanoma of the esophagus(PMME).Methods:One case of PMME was reported and literatures were reviewed.Results:The main clinical symptom of PMME was evolutional difficulty in deglutition.Microscopically,the tumor cells were arranged in nest,and pigmentation within the cytoplasm.The tumor cells were large and varied with abundant cytoplasm and large nucleus.The nucleolus can be visible,eccentrically located,and obvious nuclear division.The melanin increased significantly in the surrounding squamous epithelial basal layer and the junction of the epithelium and the stroma nested or layered.Tumor invaded into the submucosa without lymph node metastasis.Conclusion:PMME is a rare subtype of esophagus carcinoma and highly malignant,with poor prognosis.Immunohistochemical staining can help its diagnosis and differential diagnosis from other malignant tumor of the esophagus.
作者
陈琛
康林
李冰洁
陈小悦
赵焕芬
Chen Chen;Kang Lin;Li Bingjie;Chen Xiaoyue;Zhao Huanfen(Department of Pathology,Hebei Provincial People's Hospital,Hebei Shijiazhuang 050051,China)
出处
《现代肿瘤医学》
CAS
2020年第17期2981-2985,共5页
Journal of Modern Oncology
关键词
食管肿瘤
恶性黑色素瘤
免疫组化
鉴别诊断
esophagus neoplasms
malignant melanoma
immunohistochemistry
differential diagnosis
