Voit Christiane A, van Akkooi Alexander C J, Eggermont Alexander M M, Tüttenberg Andrea
aDepartment of Dermatology, Charité, Humboldt University of Berlin, Berlin bDepartment of Dermatology, University of Mainz, Mainz, Germany cDepartment of Surgical Oncology, Erasmus University Medical Center, Daniel den Hoed Cancer Center, Rotterdam, The Netherlands dInstitute Gustave Roussy Cancer Center, Villejuif, Paris Sud, France.
Melanoma Res. 2014 Oct;24(5):517-21. doi: 10.1097/CMR.0000000000000105.
We report on the case of a 41-year-old man with a recently diagnosed amelanotic ulcerated melanoma, with a Breslow thickness of 3.5 mm and Clark level IV. He had a pre-existing mass in the axilla, which had grown in parallel to the developing tumor. A large regional lymph node was clinically suspected. Ultrasound (US) examination of the axilla showed a large benign lipoma but also a very atypical peripheral perfusion. At the same time, a sentinel node showed a peripheral perfusion on US. Fine-needle aspiration cytology was performed of the different lesions and showed a melanoma metastasis in the sentinel node. Thereafter, a lymph node dissection was performed. The lipoma was seen in histopathology and even the peripheral perfusion was confirmed. US and US-guided fine-needle aspiration cytology can be easily applied in the diagnosis of lymph node metastases in melanoma patients and can help determine a benign or a malignant involvement.
我们报告了一例41岁男性患者，其最近被诊断为无色素性溃疡性黑色素瘤，Breslow厚度为3.5毫米，Clark分级为IV级。他腋窝处先前就有一个肿块，该肿块与正在发展的肿瘤同步生长。临床上怀疑有一个大的区域淋巴结。对腋窝进行超声（US）检查显示有一个大的良性脂肪瘤，但也有非常不典型的周边灌注。与此同时，前哨淋巴结在超声检查中显示有周边灌注。对不同病变进行了细针穿刺细胞学检查，结果显示前哨淋巴结中有黑色素瘤转移。此后，进行了淋巴结清扫术。组织病理学检查发现了脂肪瘤，甚至周边灌注也得到了证实。超声及超声引导下细针穿刺细胞学检查可轻松应用于黑色素瘤患者淋巴结转移的诊断，并有助于确定是良性还是恶性累及。
