Kato N, Ueno H
Department of Dermatology, Otaru City General Hospital, Japan.
J Dermatol. 1990 Sep;17(9):569-74. doi: 10.1111/j.1346-8138.1990.tb01697.x.
A firm, dark reddish, smooth surfaced nodule on the forearm of a 16-year-old boy was diagnosed as a Spitz nevus with the aid of a strong positive reactivity to S-100 protein. Histological examination revealed an intradermal epithelioid cell tumor with prominent multinucleated giant cells, suggesting the diagnosis of reticulohistiocytic granuloma. However, immunoperoxidase staining of the tumor cells showed strong positive reactivity to S-100 protein and vimentin; it was negative for lysozyme and alpha-1 antitrypsin. Although a few melanosomes in the tumor cells seen in electron microscopic examination provided crucial proof for the diagnosis of Spitz nevus, the positive reactivity to S-100 protein in ordinary formalin-fixed, paraffin-embedded tissues proved to be very useful in the differentiation of Spitz nevus from tumors of histiocytic origin, especially those of the mononuclear phagocytic system.
一名16岁男孩前臂上有一个质地坚硬、暗红色、表面光滑的结节，借助对S-100蛋白的强阳性反应被诊断为斯皮茨痣。组织学检查显示为真皮内上皮样细胞瘤，有突出的多核巨细胞，提示诊断为网状组织细胞肉芽肿。然而，肿瘤细胞的免疫过氧化物酶染色显示对S-100蛋白和波形蛋白呈强阳性反应；对溶菌酶和α-1抗胰蛋白酶呈阴性。尽管电子显微镜检查中在肿瘤细胞中发现的一些黑素体为斯皮茨痣的诊断提供了关键证据，但在普通福尔马林固定、石蜡包埋组织中对S-100蛋白的阳性反应被证明在区分斯皮茨痣与组织细胞来源的肿瘤，尤其是单核吞噬系统肿瘤方面非常有用。
