全身转移性黑素瘤1例

A Case of Cutaneous Malignant Melanoma Metastatic to Whole Body

患者女,60岁。头面、躯干、四肢大小不等黑红色结节,无痛痒3年,半年内泛发全身。皮肤科情况:头面、躯干、四肢见大小不等高粱粒至黄豆大小结节,呈皮色、暗红色及黑色。左膝关节上方见一直径约2cm×2cm大小肿块,其上见4～5个大小不等皮色至黑色结节,部分结节表面结痂。皮损组织病理示:真皮内弥漫性肿瘤样细胞浸润,此肿瘤样细胞核大、核仁明显,部分肿瘤样细胞呈巢状排列,肿瘤组织内见坏死。免疫组织化学染色显示肿瘤细胞LCA(-),CK20(-),S100蛋白及HMB45弥漫强阳性,Vimentin弥漫阳性。诊断:黑素瘤。

A 60-year old female presented with a 3-year history of black or red rashes of varying sizes on her head, face, trunk, upper and lower limbs. The number of rashes was increasing during last 6 months. Physical ex- aminations showed skin-color, dark red and black nodules on her head, face, trunk, upper limbs and lower limbs in size of sorghum grain to bean. A mass on her left knee in size of2cm×2cm with 4-5 skin-color or black nodules of varying size on it, some of the nodules covered with scabs. Histopathological examination showed infiltration of crowded tumor-like cells in the dermis. The tumor-like cells had large nuclei and prom- inent nucleoli. And the arrangement of these cells was nest-shape with necrosis within the tumor tissue. Im- munohistochemical stain showed tumor cells were LCA and CK20 negative, S100 and HMB45 diffusely strong positive, vimentin diffuse positive. Based on the above findings, the diagnosis was melanoma.