Oster-Schmidt C, Rütten A, Altmeyer P, Stücker M
Dermatologische Klinik, Ruhr-Universität Bochum, Gudrunstrasse 56, 44791 Bochum.
Hautarzt. 2001 Feb;52(2):143-6. doi: 10.1007/s001050051279.
Malignant melanomas normally arise at the dermoepidermal junction. Development of these tumours in deeper layers of the dermis without having contact with the junction is rare. A small congenital melanocytic nevus localized in the region of the waist band was excised because of mechanical irritation; it had not shown any changes over years. A thorough examination of the whole body did not give any clue to a malignant melanoma. Histologically a compound nevus with the typical architecture of a congenital melanocytic nevus was found. In the deeper dermis there was an isolated nodule of extremely atypical melanocytes with minimal pigmentation of melanin. S100 antigen could be demonstrated throughout the whole tumour whereas HMB45 was only found at the dermoepidermal junction. There was no marking of the tumour cells with a pancytokeratin antibody. A histological relationship between the new tumour and a mixed tumour of the left testicle, which had been excised 3 years ago, could be excluded. We did not find any metastases neither by image-aided methods nor by sentinel lymph node biopsy.
恶性黑色素瘤通常发生于真皮表皮交界处。这些肿瘤在真皮深层发生且不与交界处接触的情况很少见。因机械性刺激，切除了位于腰带部位的一个小先天性黑素细胞痣；多年来它未出现任何变化。对全身进行的全面检查未发现任何恶性黑色素瘤的线索。组织学检查发现一个具有先天性黑素细胞痣典型结构的复合痣。在真皮深层有一个孤立的结节，由极不典型的黑素细胞组成，黑色素沉着极少。在整个肿瘤中均可检测到S100抗原，而HMB45仅在真皮表皮交界处发现。肿瘤细胞未被全细胞角蛋白抗体标记。可排除新肿瘤与3年前切除的左侧睾丸混合瘤之间的组织学关联。无论是通过影像学辅助方法还是前哨淋巴结活检，均未发现转移。
