Laryngoscope. 2014 Jun;124(6):E241-4. doi: 10.1002/lary.24507.
OBJECTIVES/HYPOTHESIS: Melanin is a pigmented polymer with a known role in dermal solar protection. In vertebrates, melanogenesis has been reported in leukocyte populations, suggesting a potential role in innate immunity. In this study, we report the novel finding of melanin associated with chronic inflammation and speculate on its potential role in the middle ear and mastoid.
Retrospective review of case series.
Medical records of six patients who demonstrated melanin in the ear were reviewed.
Six patients from 1 to 63 years of age were identified with extracellular melanin and melanin-laden histiocytes within the middle ear and/or mastoid air cells at time of surgery. Concurrent intraoperative findings included cholesteatoma (n = 3), chronic suppurative otitis media (n = 2), and coalescent mastoiditis (n = 1). Histologically, extracellular melanin and melanin-laden histiocytes were identified by Fontana-Masson stain; absence of melanocytes was confirmed by the absence of Melan-A staining. One patient had a positive stain for CD163 (a marker for macrophages).
This case series is the first demonstration of melanin within middle ear mucosa without melanocytes in immediate proximity or metastatic melanocytic lesions. Melanin's presence in the setting of inflammation suggests that there may be a heretofore unreported link between the pigmentary and immune systems in the middle ear.
目的/假设：黑色素是一种色素聚合物，已知在皮肤的太阳保护中具有作用。在脊椎动物中，已报道白细胞群体中存在黑色素生成，表明其在先天免疫中可能具有作用。在这项研究中，我们报告了黑色素与慢性炎症相关的新发现，并推测其在中耳和乳突中的潜在作用。
病例系列回顾性研究。
回顾了六名患者的病历，这些患者在手术时表现出中耳和/或乳突气房中有黑色素和黑色素吞噬细胞。同时发现包括胆脂瘤（n=3）、慢性化脓性中耳炎（n=2）和融合性乳突炎（n=1）。组织学上，通过Fontana-Masson 染色鉴定细胞外黑色素和黑色素吞噬细胞；缺乏 Melan-A 染色证实了黑色素细胞的不存在。一名患者的 CD163（巨噬细胞标志物）染色为阳性。
这一系列病例是首例在没有邻近黑色素细胞或转移性黑色素瘤病变的情况下，在中耳黏膜中发现黑色素的报道。在炎症环境中黑色素的存在表明，在中耳的色素和免疫系统之间可能存在以前未被报道的联系。
4 级。
