Chen J H, Meng C L, Chao L S, Tu C N, Shyu K W
Zhonghua Ya Yi Xue Hui Za Zhi. 1989 Jun;8(2):80-9.
A 24 year-old male with painful swelling over the right side of his palate for about two weeks was presented. An incisional biopsy was performed. In a routine hematoxylin and eosin examination by light microscopy, spindle and epithelioid cells with a bizarre appearance were discernible in the submucosal area. A pagetoid pattern was found in areas of the epithelium. Since this is not a remarkable finding, further examinations, such as the Trichrome-Masson and silver stain, immunohistochemistry using cytokeratin, vimentin, S-100, leukocyte common antigen, factor VIII, and alpha-1-antichymotrypsin detection kits, and electron microscopy were all carried out. According to the histological pattern of cells and the positive findings from the special stains, immunohistochemistry, and electron microscopy, a diagnosis of desmoplastic amelanotic melanoma was made. This variant of melanoma is a rare disorder with unremarkable, non-specific clinical manifestations in the oral cavity, which makes the diagnosis of this disease more difficult. We, therefore, report one case of this disease. Owing to the fact that diagnosis of this variant was mainly based on the positive findings of vimentin and S-100 in the immunohistochemistry examination and intracellular premelanosome detected by electron microscopy, immunodiagnosis and electron microscopy seem to be essential for differential diagnosis.
一名24岁男性，腭右侧疼痛性肿胀约两周，前来就诊。进行了切开活检。在苏木精和伊红染色的常规光学显微镜检查中，在黏膜下区域可发现外观怪异的梭形细胞和上皮样细胞。上皮区域发现派杰样模式。由于这不是一个显著的发现，因此进行了进一步检查，如三色-马松染色和银染色、使用细胞角蛋白、波形蛋白、S-100、白细胞共同抗原、因子VIII和α-1-抗糜蛋白酶检测试剂盒的免疫组织化学检查以及电子显微镜检查。根据细胞的组织学模式以及特殊染色、免疫组织化学和电子显微镜检查的阳性结果，诊断为促纤维增生性无黑色素性黑色素瘤。这种黑色素瘤变体是一种罕见疾病，在口腔中临床表现不明显且无特异性，这使得该病的诊断更加困难。因此，我们报告了1例该疾病。由于该变体的诊断主要基于免疫组织化学检查中波形蛋白和S-100的阳性结果以及电子显微镜检测到的细胞内前黑素小体，免疫诊断和电子显微镜检查似乎对鉴别诊断至关重要。
