Yamazaki K, Ohmori T, Kumagai Y, Makuuchi H, Eyden B
Department of Pathology, School of Medicine, Keio University, Tokyo, Japan.
Virchows Arch A Pathol Anat Histopathol. 1991;418(6):515-22. doi: 10.1007/BF01606502.
Four examples of an endoscopically detected oesophageal melanotic lesion were examined by light microscopy, light microscope histochemistry and transmission electron microscopy, and were compared with 13 control samples of normal oesophageal epithelium. By light microscopy, pigmented melanocytes lacking atypia and mitoses were observed amongst the keratinocytes in the basal layer of the oesophageal mucosa. Junctional activity was absent. The mechanism of pigmentation was studied and found to consist of: an increase in the number of melanocytes in the basal layer of the mucosa, an increase in the quantity of melanin in these melanocytes, transfer of melanin from melanocytes to keratinocytes and to macrophages and fibroblasts in the tunica propria. Since all the lesions demonstrated increased numbers of both melanocytes and melanosomes, the term oesophageal melanocytosis rather than melanosis is suggested, to emphasise the essential character of the lesion as a cellular proliferation. The value of sampling these pigmented lesions during endoscopy is emphasised as a means of obtaining well-preserved material for the evaluation of a lesion which some authorities have viewed as a possible precursor for oesophageal malignant melanoma.
对4例经内镜检查发现的食管黑色素沉着性病变进行了光镜、光镜组织化学及透射电镜检查，并与13例正常食管上皮对照样本进行了比较。光镜下，在食管黏膜基底层的角质形成细胞中观察到无细胞异型性和有丝分裂的色素沉着黑素细胞。未见交界活性。对色素沉着机制进行了研究，发现其包括：黏膜基底层黑素细胞数量增加、这些黑素细胞内黑色素量增加、黑色素从黑素细胞转移至角质形成细胞以及固有层中的巨噬细胞和成纤维细胞。由于所有病变均显示黑素细胞和黑素小体数量增加，因此建议使用食管黑素增多症而非黑素沉着症这一术语，以强调该病变作为细胞增殖的本质特征。强调了在内镜检查期间对这些色素沉着病变进行采样的价值，以此作为获取保存良好的材料以评估病变的一种手段，一些权威机构认为该病变可能是食管恶性黑色素瘤的前驱病变。
