眼内无色素性恶性黑色素瘤的光镜电镜免疫组化研究

The histopathological ultrastructural and immunohistochemical study of the intraocular amelanotic malignant melanoma

目的:探讨眼内无色素性恶性黑色素瘤的光镜、电镜、免疫组化特征,为其诊断和鉴别诊断提供依据。方法:常规石蜡切片HE染色、组织化学染色,透射电镜及免疫组化检查。结果:瘤细胞弥散排列,大部分瘤细胞圆形、椭圆形、多边形,大小不等,胞浆丰富,呈细颗粒状、细网状或空泡状,淡嗜碱性,核圆形、椭圆形,异型明显。苏丹Ⅲ染色部分瘤细胞阳性,嗜银染色少量瘤细胞阳性;透射电镜部分瘤细胞胞浆内含有黑色素小体;免疫组化S-100、Vimentin、HMB45阳性,Keratin阴性。结论:眼内无色素性恶性黑色素瘤除光镜下瘤细胞胞浆内不见黑色素外,其余组织学、电镜及免疫组化特征均同恶性黑色素瘤相似,可通过组织学与电镜或免疫组化检查确诊。

To investigate the histopathological, ul-trastmctural and immunohistochemical characteristics of the intraocular amelanin malignant melanoma for the support of its diagnosis and differential diagnosis. Methods: Routine paraffin wax section, Hematoxylin and Eosin stain, histochemical stain and electron microscopy as well as immunohistochemistry were used. Results: The tumor cells were dispersively arranged. Most of the tumor cells were round or oval, with abundant fine granular,fine reticulate , or vacuolated cytoplasm. The nucleus were round or oval, distinctive pleomorphic. Some of the tumor cells are observed to be markedly lipidized with frozen sections stained with Sudan Ⅲ . A few of the tumor cells were surrounded by argyrophilic fibers in Gomori stains. Transmis-sion electron microscopy revealed melanosomes in some cells. Immunohistochemistry showed positive for S-100, HMB45 and Vimentin,but negative for Keratin. Conclusion; The specific diagnosis of the intraocular amelanin malignant melanoma can be confirmed by histopathological, ultrastructural and immunohistochemical examinations .