Jennings T A, Axiotis C A, Kress Y, Carter D
Department of Pathology, Albert Einstein College of Medicine, Bronx, New York.
Am J Clin Pathol. 1990 Nov;94(5):649-55. doi: 10.1093/ajcp/94.5.649.
The authors report a case of primary bronchial malignant melanoma, occurring in a 34-year-old woman presenting with persistent cough. At bronchoscopic examination, a polypoid mass was found to occlude the left mainstem bronchus. Biopsies showed a malignant epithelioid tumor resembling an atypical carcinoid. Histochemistry, electron microscopic study, and immunohistochemistry confirmed the diagnosis of melanoma. Physical examination and additional clinical history to exclude other possible primary sites were negative. The patient underwent thoracotomy with left pneumonectomy. Nineteen months after resection she was found to have a histologically similar tumor involving her left adrenal gland. Review of the literature shows that melanoma of the lower respiratory tract has been reported only in adults and has a tendency to present as a central polypoid growth that may be responsive to surgical resection.
作者报告了一例原发性支气管恶性黑色素瘤病例，患者为一名34岁女性，表现为持续性咳嗽。支气管镜检查时，发现一个息肉样肿物阻塞左主支气管。活检显示为恶性上皮样肿瘤，类似非典型类癌。组织化学、电子显微镜研究及免疫组织化学检查均确诊为黑色素瘤。体格检查及进一步临床病史检查以排除其他可能的原发部位，结果均为阴性。患者接受了开胸左肺切除术。切除术后19个月，发现她的左肾上腺有一个组织学上相似的肿瘤。文献回顾显示，下呼吸道黑色素瘤仅在成人中报道过，且倾向于表现为中央息肉样生长，可能对手术切除有反应。
