Angelucci D, Natali P G, Amerio P L, Ramenghi M, Musiani P
Department of Human Pathology, University of Chieti, Italy.
Hum Pathol. 1991 Mar;22(3):297-301. doi: 10.1016/0046-8177(91)90165-l.
Transformation to malignant melanoma in a giant congenital melanocytic nevus observed on the right limb of a 3,300-g newborn boy was strongly suggested by the histologic features of its ulcerated and papular areas: atypical melanocytes, irregular melanin distribution, many mitotic figures, "pagetoid" invasion of the dermis, and destruction of the rete ridges. Electron microscopy, too, showed that the atypical melanocytes had irregularly shaped and folded nuclei, one or more nucleoli, and a cytoplasm rich in organelles and polymorphous melanosomes. Investigation with a panel of monoclonal antibodies, on the other hand, revealed the antigen phenotype of a proliferative melanocytic lesion unaccompanied by the plain expression of antigens usually observed in malignant melanoma. In addition, the clinical picture during a 2-year follow-up has been free from signs of locoregional and systemic progression.
一名体重3300克的新生男婴右上肢的巨大先天性黑素细胞痣出现溃疡和丘疹区域，其组织学特征强烈提示已转变为恶性黑色素瘤：非典型黑素细胞、黑色素分布不规则、许多有丝分裂象、真皮的“派杰样”浸润以及表皮嵴破坏。电子显微镜检查也显示，非典型黑素细胞具有形状不规则且折叠的细胞核、一个或多个核仁，以及富含细胞器和多形性黑素小体的细胞质。另一方面，用一组单克隆抗体进行研究发现，增殖性黑素细胞病变的抗原表型并未伴随恶性黑色素瘤中通常观察到的抗原的明显表达。此外，在两年的随访期间，临床表现未出现局部和全身进展的迹象。
