胃肠道转移性恶性黑色素瘤6例临床病理观察及误诊分析

Clinicopathologic observation and misdiagnosis analysis of 6 cases of gastrointestinal metastatic malignant melanoma

目的探讨胃肠道转移性恶性黑色素瘤的临床病理特征,讨论需要鉴别诊断的疾病并吸取误诊教训。方法收集胃肠道转移性恶性黑色素瘤6例,回顾性分析其临床资料、HE、免疫组化及病理诊断结果。结果 6例中除了2例因临床及病理特征典型首次活检即被确诊外,其余4例均被误诊。2例误诊为非霍奇金淋巴瘤,1例误诊为低分化腺癌,1例误诊为胃肠间质瘤。结论胃肠道转移性恶性黑色素瘤少见,无色素胃肠道转移性恶性黑色素瘤易误诊,遇到分化较差的胃肠道恶性肿瘤应行免疫组化检查。

Objective To investigate gastrointestinal metastatic malignant melanoma clinicopathological features,discusses the necessity for differential diagnosis and learn the lessons of those misdiagnoses.Methods All of collecting gastrointestinal metastatic malignant melanoma in 6 cases,retrospective analysis of the clinical data,HE,immunohistochemical and pathological diagnosis.Results Two of 6 cases in this group were confirmed,which were due to clinical and pathological features of typical first biopsy,and those others were misdiagnosed.In these 4 misdiagnosed cases,2 cases of them were misdiagnosed as non hodgkin lymphoma,and 1 case was misdiagnosed as poorly differentiated adenocarcinoma,and the last was misdiagnosed as gastrointestinal stromal tumor.Conclusion Gastrointestinal metastatic malignant melanoma is rare in clinic,and amelanotic metastatic gastrointestinal malignant melanoma easily misdiagnosed,when met a poorly differentiated malignant tumors in gastrointestinal tract the immunohistological examination should be necessary.