Stante M, Carli P, Massi D, de Giorgi V
Department of Dermatology, University of Florence, Florence, Italy.
Clin Exp Dermatol. 2003 Sep;28(5):476-80. doi: 10.1046/j.1365-2230.2003.01332.x.
Little is currently known about the relationship between melanocytic naevi and melanoma in terms of neoplastic progression. At histological examination, remnants of a pre-existing melanocytic naevus adjoining a melanoma are seen in 20-30% of cases. This study investigated dermoscopic features of 108 naevus-associated melanomas, identified on the basis of histological classification, consecutively observed at a University Department. Because of the risk of misclassification due to destruction of naevus remnants in thick tumours, only lesions of < 1 mm Breslow thickness were considered. We found naevus-associated melanomas showing atypical pigment networks and regression patterns more frequently than de novo melanomas, while irregular blotches and atypical vascular patterns were found less frequently. Dermatologists should be aware that dermoscopic features of melanoma differ according to the histogenesis of the lesion. Atypical pigment networks and regression patterns are the most useful dermoscopic criteria suggested to make a diagnosis of naevus-associated melanoma.
目前,关于黑素细胞痣与黑色素瘤在肿瘤进展方面的关系,人们所知甚少。在组织学检查中,20%至30%的病例可见毗邻黑色素瘤的先前存在的黑素细胞痣残余。本研究调查了108例痣相关黑色素瘤的皮肤镜特征,这些病例是根据组织学分类确定的,在一所大学附属医院连续观察得到。由于厚肿瘤中痣残余被破坏会导致错误分类的风险,因此仅考虑 Breslow厚度<1mm的病变。我们发现,与新发黑色素瘤相比,痣相关黑色素瘤更频繁地表现出非典型色素网络和消退模式,而不规则斑片和非典型血管模式则较少见。皮肤科医生应意识到,黑色素瘤的皮肤镜特征因病变的组织发生而异。非典型色素网络和消退模式是建议用于诊断痣相关黑色素瘤的最有用的皮肤镜标准。