脉络膜恶性黑色素瘤的临床病理观察

Clinicopathological observation of choroidal malignant melanoma

目的 观察脉络膜恶性黑色素瘤的临床病理特征及影响预后的因素。方法 对 19例脉络膜恶性黑色素瘤进行了临床病理观察 ,部分病例检测了 S10 0、HMB45及超微结构观察。结果 男 11例 ,女 8例 ,平均年龄5 5 .4岁 ;均为单眼患病 :右眼 12例 ,左眼 7例 ;影像学检查示眼内占位。眼底荧光素血管造影显示“双循环”现象。组织学表现以梭形细胞为主。免疫表型 6例 ,S10 0、HMB45均为阳性。 3例电镜下显示了肿瘤细胞内数量不等的黑色素小体。结论 脉络膜恶性黑色素瘤应综合临床及辅助检查争取早期诊断、手术治疗。其预后与肿瘤的大小、细胞类型、侵犯范围等有关。

Objective To study the clinic pathological characteristics of choroidal malignant melanoma and the relationship to prognosis.Methods The cliniopathological date of 19 cases of choroidal malignant melanoma were studied.Some cases were performed by immunohistochemical and ultrastructual observation.Results The patients were 11 males,8 females with the average of 55.4 years.Alesions was in single eye(right:12 cases,left:7 cases).There had masses in ocular by imagedogical examination.'Double circulation'was showed by fundus fluorescence angiography.Histologically,it was consist of spindle cells mainly.Immunohistochemical staining for S100,HMB45 was positive in all 6 cases.Tumor cells had variably melanin granules in 3 cases under electronmicroscope.Conclusion The choroidal malignant melanoma could de diagnosis early by various examination,it should be operated early.The prognosis was related to the tumor size,histological classification and its affected areas.Using immunohistochemical and electronmicroscopic methods would help to diagnosis the non-melanin of malignant melanoma.