Fornage B D, Lorigan J G
Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston 77030.
J Ultrasound Med. 1989 Aug;8(8):421-4. doi: 10.7863/jum.1989.8.8.421.
Subcutaneous or lymph node metastases from melanoma may not be palpable because of their small size, their distance from the skin surface, or their location in an area of fibrosis due to previous surgery or irradiation. High-resolution sonography has been used to detect clinically occult foci of recurrent or metastatic melanoma, whereas real-time, ultrasound-guided, fine-needle aspiration biopsy provided cytologic confirmation. Following excision of cutaneous melanoma, sonographic follow-up of the areas of the surgical scar and lymphatic drainage is recommended whenever residual disease is suspected or when clinical evaluation is limited by postoperative or postradiation changes. Any nonpalpable hypoechoic mass detected in those areas should have a biopsy under real-time sonographic guidance.
黑色素瘤的皮下或淋巴结转移灶可能因体积小、距皮肤表面较远或位于既往手术或放疗所致纤维化区域而无法触及。高分辨率超声已被用于检测复发性或转移性黑色素瘤的临床隐匿病灶，而实时超声引导下细针穿刺活检则提供了细胞学确诊依据。切除皮肤黑色素瘤后，只要怀疑有残留病灶或临床评估受术后或放疗后改变限制，就建议对手术瘢痕和淋巴引流区域进行超声随访。在这些区域检测到的任何无法触及的低回声肿块都应在实时超声引导下进行活检。
