鼻腔恶性黑色素瘤临床病理特点

Clinical Pathological Features of Malignant Mela Noma in the Nasal Cavity

目的探究鼻腔恶性黑色素瘤的临床病征,分析研究该病的诊断,增加对该病的了解。方法分析该院从1996年12月—2016年12月的50例鼻腔恶性黑色素瘤患者的临床资料,观察这些患者的临床病理特征,并展开免疫组化分析。结果巨检中,送检组织中有15例为紫黑色,18例为灰红,17例为灰黑,镜检中,18例由大上皮样细胞构成,9例在大上皮细胞中可以看到梭形细胞的成分,12例由类似于小的淋巴细胞构成,11例由多种细胞构成,32例细胞黑色素明显,15例细胞黑色素较少,3例细胞没有黑色素存在免疫组化标记肿瘤组织HMB45、S-100以及Vim全部(+)。结论鼻腔恶性黑色素瘤容易被误诊当做成别的鼻腔原发性的肿瘤,使临床上的治疗发生错误,延误了肿瘤的最佳治疗时期,并且诊断起来也相对困难,我们可以通过肿瘤的组织学的变化和进行免疫组化标记与其它鼻腔肿瘤区分开来,从而进行正确的临床治疗。

Objective To explore the clinical pathological features of malignant mela noma in the nasal cavity and analyze and research the diagnosis of the disease in order to increase the awareness of the disease. Methods 50 cases of patients with malignant mela noma in the nasal cavity in our hospital from December 1996 to December 2016 were selected and the clinical pathological features were observed for immunohistochemical analysis. Results In the macroexamination, there were 15 cases of atropurpureus, 18 cases of grey red and 17 cases of grey black, in the microscopy, 18 cases were composed of large epithelioid cells, and the components of spindle cell could be seen from 9 cases of epithelial cells, 12 cases were composed of small lymphocyte, 11 cases were composed of multiple cells, the cell melanin of 32 cases was obvious, of 15 cases was lower and of 3 cases was 0, and there were immunohistochemical tumor tissues of HMB45,S-100 and Vim all（＋）. Conclusion The malignant mela noma in the nasal cavity is easy to be misdiagnosed with primary tumors in other nasal cavities, thus making misdiagnosis in clinical treatment and delaying the best treatment time of tumors, and the diagnosis is relatively difficult, and we can distinguish it from tumors in other nasal cavity region by changes of tumor histology and making the immunohistochemical signs, thus making the accurate treatment.