宫颈原发性恶性黑色素瘤临床及病理学特征分析

Clinical and pathological characteristics of primary malignant melanoma of cervix

目的探讨宫颈原发性恶性黑色素瘤的临床及病理特征。方法对2例宫颈原发性恶性黑色素瘤患者临床特征及组织标本苏木精-伊红(HE)染色和免疫组织化学染色检查结果进行回顾性分析。结果 2例女性患者分别为46和58岁,均以阴道流血及宫颈肿块为主要症状,肿块呈息肉状和结节状伴糜烂、溃疡及出血。HE染色可见组织结构复杂,细胞类型多样,主要以上皮样或组织样细胞及梭形细胞主,可见散在的多核巨细胞;细胞异形性明显,可见核分裂象,黑色素颗粒可有可无。免疫组织化学染色显示S-100蛋白、人黑色素瘤标记物45(HMB45)及波形蛋白(Vimentin)均呈阳性表达,平滑肌肌动蛋白(SMA)、白细胞共同抗原(LCA)、细胞角蛋白(CK)、上皮膜抗原(EMA)、结蛋白(Desmin)、神经元特异性烯醇化酶(NSE)、突触素(syn)均呈阴性表达。结论宫颈原发性恶性黑色素瘤极其罕见,恶性程度高,对放、化疗均不敏感,病死率高,预后差。普及宫颈恶性肿瘤筛查对该病的预防和治疗极为重要。

Objective To explore the clinical and pathological features of primary malignant melanoma of cer-vix （PMMC）.Methods Clinical characteristics and pathological detection results of hematine-eosin （HE）and immu-nohistochemistry stain were retrospectively analyzed in tow cases with PMMC.Results Two female patients at age of 46 and 58 years old presented with vaginal bleeding and polypoid mass with erosions,ulcers and bleeding.HE stain indicated that the lesions were composed of three cell types,including epithelial-like cells,spindle cells and polykaryo-cytes.The cellular atypia and mitotic were visible.Tumor cells showed positive for S-100 protein,human melanoma marker 45 （HMB45）,vimentin,but negative for smooth muscle actin （SMA）,leukocyte common antigen （LCA）,cy-tokeratin （CK）,epithelial membrane antigen （EMA）,Desmin,neuron specific enolase （NSE）and synaptophysin （syn）.Conclusion PMMC could be extremely rare,not sensitive to radiotherapy and chemotherapy,possess high mortality and poor prognosis.Cervical cancer screening should be advocated for the prevention and therapy of this disease.