Saint-Blancard P, Vaylet F, Jancovici R
Service d'Anatomie et de cytologie pathologiques, Hôpital d'Instruction des Armées Percy, Clamart, France.
Rev Mal Respir. 2009 Jan;26(1):57-61. doi: 10.1016/s0761-8425(09)70135-4.
Malignant melanoma most commonly presents as a primary neoplasm of the skin, but has been described in other mucosal sites. Rarely, malignant melanomas have been reported as primary visceral neoplasms, including the lung. Most such lesions have been dismissed as metastases from undocumented or regressed primary cutaneous or ocular melanomas.
We report an original observation of an 82-year-old man with a pulmonary nodule presenting with chest pain. The diagnosis of melanoma was established on biopsies carried out under computerized tomography scanning and confirmed after right upper lobectomy two months later.
Melanomas of the respiratory tract are usually metastatic in origin and a primary melanoma in very rare. Strict criteria must be applied before a diagnosis of primary malignant melanoma of lower respiratory tract can be accepted. Melanoma may be confused with more conventional types of lung cancer and other pigmented tumours.
恶性黑色素瘤最常见的表现是皮肤原发性肿瘤，但也有在其他黏膜部位出现的报道。极少情况下，恶性黑色素瘤被报告为原发性内脏肿瘤，包括肺部。大多数此类病变被认为是来自未记录或已消退的原发性皮肤或眼部黑色素瘤的转移灶。
我们报告了一例82岁男性因肺部结节伴胸痛的原始观察病例。在计算机断层扫描引导下进行活检确诊为黑色素瘤，并在两个月后右上叶切除术后得到证实。
呼吸道黑色素瘤通常起源于转移，原发性黑色素瘤非常罕见。在接受下呼吸道原发性恶性黑色素瘤的诊断之前，必须应用严格的标准。黑色素瘤可能与更常见的肺癌类型和其他色素性肿瘤相混淆。
