11例肛管直肠恶性黑色素瘤临床病理分析

Pathological features of anorectal malignant melanoma

目的探讨肛管直肠恶性黑色素瘤(AMM)的临床病理特征,对其诊断和鉴别诊断进行讨论。方法收集11例肛管直肠恶性黑色素瘤,观察其临床病理特点并进行免疫组化分析。结果11例肛管直肠恶性黑色素瘤中男4例,女7例;年龄34～75岁,平均55.8岁。镜检示肿瘤结构复杂,细胞形态多样,瘤细胞由上皮样、梭形及未分化小细胞等多种细胞构成。免疫组化标记瘤组织HMB45、S-100和Vim(+)。结论肛管直肠恶性黑色素瘤与皮肤恶性黑色素瘤相比具有不同的组织形态学特征,通常诊断较困难。HMB45和S-100是恶性黑色素瘤较为敏感的标记物,与Vim和CK联合应用有助于与肛管直肠其他原发肿瘤相鉴别。

Objective To study the clinicopathological characteristics,differential diagnosis,epidemiology and etiological factor of anorectal malignant melanoma （AMM）. Have a discussion about its diagnosis and differential diagnosis. Methods Clinical pathological characteristic and immunohistochemical findings were observed in 11 cases of anorectal malignant melanoma,with review of relatated literature. Results In the 11 cases of anorectal malignant melanoma（AMM）,4 cases of male and 7 cases of femal. The ages were form 34-75 years old. Average age was 55. 8. Under microscope,the tumor was complicated constructionally,and the tumor cells were variform. There were several kinds tumor cells,including epithelioid cell,spindle cell and undivided small cell. Immunohistochemical staining showed that the tumor cells were positive for HMB45,S-100 and Vimentin. Conclusion Compared with skin malignant melanoma,anorectal malignant melanoma has different histopatho-logic characteristics. Usually,it is difficult to diagnose. HMB45 and S-100 are sensitive tumor makers for AMM, If combined application with Vimentin and cytokeratin,it would be helpful to distinguish anorectal and pimary tumor.