无色素性恶性黑色素瘤的形态多样性

Morphologic diversity in amelanotic malignant melanomas

无色素性恶性黑色素瘤（恶黑）是病理诊断中常见的难题，到底有哪些形态表现，尚未见综合性归纳，故有必要将其形态的多样性予以讨论．本组共收集无色素性恶黑４７例，均经电镜、免疫组化或临床随诊证实．其中男２５例，女２２例，年龄１４～７５岁．发生部位皮肤６例，软组织内１２例，口、鼻腔７例，消化道１１例，转移至淋巴结３例，脑及脑膜４例，其余为眼、肝脏、乳腺、阴茎各１例．组织结构上有１０种形态，细胞学上有１４种形态．充分认识恶黑的多样性为光镜下的鉴别诊断提供帮助．

One of the most often cited lesions that can simulate other tumors is amelanotic malignant melanoma(AMM). A review was conducted of 47 AMM to identify various morphologic patterns that might be confused with other tumors. There were 25 men and 22 women,ranging in age from 14 to 75 years at diagnosis. Their melanomas arose in a variety of anatomic locations, including the skin, soft tissue, oral and nasal regions, gastrointestinal tract, lymph node,brain and meninges, etc. Ten histological patterns and 14 cytological figures were recognized. That pay attention to the varieties of pathological changes of AMM is helpful to its differential diagnosis from other simulant diseases.