Rongioletti Franco, Smoller Bruce R
Section of Dermatology, DISEM, University of Genoa, Italy.
J Cutan Pathol. 2005 Oct;32(9):589-603. doi: 10.1111/j.0303-6987.2005.00418.x.
Malignant melanoma is known for the wide range of histological patterns it can assume mimicking other malignant tumors. We present a review of most of the unusual histological variants of cutaneous melanoma and describe their immunohistochemical features, associate clinical findings, and possible behavior related to the histological subtype. In addition, we propose their classification into four groups corresponding to the (1) architectural patterns; (2) cytologic features; (3) stromal changes; and (4) the possible association of these findings (i.e. architectural + cytologic features). Although most of these unusual variants have the same prognosis as conventional melanomas, with Breslow thickness and ulceration, being the most important predictor of survival in clinical stage I, some of them have a peculiar biologic behavior that the clinicians and the dermatopathologists should know in order to give melanoma patients all educational information available.
恶性黑色素瘤以其可呈现多种模仿其他恶性肿瘤的组织学模式而闻名。我们对皮肤黑色素瘤的大多数不寻常组织学变体进行了综述，并描述了它们的免疫组化特征、相关临床发现以及与组织学亚型相关的可能行为。此外，我们建议将它们分为四组，分别对应于：(1) 结构模式；(2) 细胞学特征；(3) 间质变化；以及 (4) 这些发现的可能关联（即结构 + 细胞学特征）。尽管这些不寻常变体中的大多数与传统黑色素瘤具有相同的预后，在临床 I 期， Breslow 厚度和溃疡是生存的最重要预测因素，但其中一些具有特殊的生物学行为，临床医生和皮肤病理学家应该了解这些行为，以便为黑色素瘤患者提供所有可用的教育信息。
