Hattori Yui, Sentani Kazuhiro, Hattori Takuya, Matsuo Yoshimi, Kawai Mikio, Shindo Hajime, Tanaka Maiko, Hide Michihiro, Yasui Wataru
Department of Molecular Pathology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan.
Department of Dermatology, Hiroshima University Institute of Biomedical and Health Sciences, Hiroshima, Japan; Department of Dermatology, Hiroshima Kyoritsu Hospital, Hiroshima, Japan.
Case Rep Oncol. 2016 Apr 27;9(1):262-6. doi: 10.1159/000446065. eCollection 2016 Jan-Apr.
Balloon cell malignant melanoma (BCMM) is a very rare malignant melanoma subtype. The clinical appearance of BCMM varies; it may be nodular, ulcerated, polypoid, papillomatous and often non-pigmented. The tumor cells histologically appear large, polygonal or round and contain abundant granular or vacuolated cytoplasm. We herein report the case of a 32-year-old female who presented with a focal eccentric pigmented mass in the left lumbar region of 15 mm in diameter that had been present for several years. She underwent tumor excision. The histopathological analysis showed epithelioid melanocytes with clear cytoplasm. An immunohistochemical analysis revealed that the cells were positive for HMB-45 and S-100 protein and negative for cytokeratin. The balloon cell component stained negative for Fontana-Masson. A month later, the patient underwent excision of the bilateral inguinal lymph nodes and metastatic BCMM was revealed. The lymph node metastases showed the complete replacement of lymph nodes by balloon cells. A diagnosis of BCMM (Breslow depth 10 mm, Clark level V) without ulcer was rendered. Staining with Ki-67 was positive in almost 44% of the balloon cells.
气球状细胞恶性黑色素瘤（BCMM）是一种非常罕见的恶性黑色素瘤亚型。BCMM的临床表现各异；它可能呈结节状、溃疡状、息肉状、乳头状，且通常无色素沉着。肿瘤细胞在组织学上显得较大，呈多边形或圆形，含有丰富的颗粒状或空泡状细胞质。我们在此报告一例32岁女性病例，其左腰部出现一个直径15毫米的局灶性偏心色素性肿块，已存在数年。她接受了肿瘤切除。组织病理学分析显示上皮样黑色素细胞，细胞质清晰。免疫组织化学分析显示细胞HMB - 45和S - 100蛋白呈阳性，细胞角蛋白呈阴性。气球状细胞成分Fontana - Masson染色呈阴性。一个月后，患者接受双侧腹股沟淋巴结切除，发现存在转移性BCMM。淋巴结转移表现为淋巴结被气球状细胞完全取代。诊断为无溃疡的BCMM（Breslow深度10毫米，Clark分级V级）。Ki - 67染色显示几乎44%的气球状细胞呈阳性。
