Allen B C, Herrera G A
Department of Pathology, University of Mississippi Medical Center, Jackson 39216.
Ultrastruct Pathol. 1991 Jan-Feb;15(1):87-97. doi: 10.3109/01913129109021308.
Characterization of poorly differentiated neoplasms can be a challenging task for the surgical pathologist. It is essential that the entire spectrum of immunomorphologic findings of various tumors be recognized to avoid improper characterization of a given neoplasm, which may in turn adversely affect patient management. Tumor characterization is complicated by the immunomorphologic transformations that malignant cells may undergo by virtue of which they may depart from expression of expected features and acquire new, unexpected characteristics. Traditionally, amelanotic melanomas have been difficult to characterize because of the diversity of their light microscopic morphology (epithelioid, spindle, and combined varieties). As a result, several other neoplasms are usually considered in the differential diagnosis. This report describes a primarily spindle-cell amelanotic melanoma that created a diagnostic dilemma, which could only be resolved by combining the information obtained from extensive evaluation by means of several diagnostic techniques. This case also stresses the phenotypic heterogeneity of the cytoskeleton of malignant melanomas and therefore their varied immunomorphologic characteristics.
对于外科病理学家而言，低分化肿瘤的特征描述可能是一项具有挑战性的任务。必须认识到各种肿瘤免疫形态学发现的全貌，以避免对特定肿瘤进行不当的特征描述，否则可能会对患者的治疗产生不利影响。肿瘤细胞可能发生免疫形态学转变，使其偏离预期特征的表达并获得新的、意想不到的特征，这使得肿瘤的特征描述变得复杂。传统上，无色素性黑色素瘤因其光镜形态的多样性（上皮样、梭形和混合型）而难以进行特征描述。因此，在鉴别诊断中通常会考虑其他几种肿瘤。本报告描述了一例主要为梭形细胞的无色素性黑色素瘤，该病例造成了诊断上的困境，只有通过综合多种诊断技术进行广泛评估所获得的信息才能解决。该病例还强调了恶性黑色素瘤细胞骨架的表型异质性，以及因此产生的不同免疫形态学特征。
