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结节性黑素瘤:43 例研究,重点在于生长模式。

Nevoid melanoma: A study of 43 cases with emphasis on growth pattern.

机构信息

Ackerman Academy of Dermatopathology, New York, New York.

Ackerman Academy of Dermatopathology, New York, New York.

出版信息

J Am Acad Dermatol. 2015 Nov;73(5):836-42. doi: 10.1016/j.jaad.2015.07.003. Epub 2015 Aug 20.

Abstract

BACKGROUND

Nevoid melanoma may be confused both clinically and histologically with benign nevi.

OBJECTIVE

The aim of this study was to characterize the histologic features of nevoid melanoma.

METHODS

Forty-three cases of nevoid melanoma from our laboratory were evaluated.

RESULTS

Our study cases included 33 men and 10 women with mean age of 62 years. The back was the most common site followed by the arm. A clinical diagnosis other than melanoma was made in about 40% of the cases. Two architectural patterns were identified: Plaque and polypoid. Sheetlike confluence of melanocytes expanding the papillary dermis was seen in 60% of the cases. Nests disposed in parallel arrays at the base of the tumor (parallel theque pattern) were present in roughly 81% of our series. Mitoses were evident in one-third of cases ranging from less than 1 to 4 per square millimeter. Genomic abnormalities characteristic of melanoma were detected in 7 of 8 tested cases.

LIMITATION

This is a descriptive study. No follow-up information was available for 32 of the 43 patients. In the other 11, follow-up was limited to the re-excision specimens.

CONCLUSION

Characteristic growth patterns including confluence of dermal melanocytes with no intervening connective tissue and the parallel theque pattern can be helpful in suggesting a diagnosis of nevoid melanoma at scanning magnification.

摘要

背景

痣样恶性黑色素瘤在临床和组织学上可能与良性痣混淆。

目的

本研究旨在描述痣样恶性黑色素瘤的组织学特征。

方法

评估了来自我们实验室的 43 例痣样恶性黑色素瘤病例。

结果

我们的研究病例包括 33 名男性和 10 名女性,平均年龄为 62 岁。背部是最常见的发病部位,其次是手臂。大约 40%的病例最初被误诊为非黑色素瘤。两种组织学模式被确定:斑块状和息肉状。约 60%的病例可见片状黑色素细胞融合,扩展到乳头真皮。肿瘤基底平行排列的巢(平行苔癣样模式)存在于我们系列中的约 81%。三分之一的病例有丝分裂,每平方毫米小于 1 到 4 个。8 例检测病例中有 7 例检测到黑色素瘤特征的基因组异常。

局限性

这是一项描述性研究。43 例患者中有 32 例没有随访信息。在其他 11 例中,随访仅限于再次切除标本。

结论

特征性的生长模式,包括无间隔结缔组织的真皮黑色素细胞融合和平行苔癣样模式,在扫描放大时有助于提示痣样恶性黑色素瘤的诊断。

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