Peng Juan, Han Fengfeng, Yang Tianyun, Sun Jinyuan, Guan Wenbin, Guo Xuejun
aDepartment of Respiratory Medicine bDepartment of Pathology, Xinhua Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, PR China.
Medicine (Baltimore). 2017 Nov;96(46):e8772. doi: 10.1097/MD.0000000000008772.
Primary malignant melanoma of the lung (PMML) is an extremely rare neoplasm with a dismal prognosis. The diagnosis of PMML is very difficult and is based on several clinical, radiological, and histopathological criteria.
A 61-year-old women was admitted with a 2-month history of a productive cough and chest pain provoked by breathing and coughing. Computed tomography (CT) scans of the chest showed a large, solid tumor in the right middle lobe of the lung. Puncture biopsy of the right lung lesion was performed using B-ultrasound guidance, and immunohistochemical tests were performed.
The diagnosis of PMML was histopathologically confirmed by puncture biopsy with B-ultrasound guidance of the right lung lesion.
The patient refused to receive surgery, adjuvant chemotherapy, or radiation therapy.
The patient died 6 months after the diagnosis.
The clinical manifestation and imaging features of PMML are not specific, and it does not differ from the more common primary bronchogenic carcinoma. In addition, it cannot be discriminated from other forms of primary melanoma according to its histology and immunohistochemistry. The treatment of choice is an aggressive surgical approach, combined with radiation therapy, chemotherapy, and immunotherapy.
原发性肺恶性黑色素瘤（PMML）是一种极其罕见的肿瘤，预后很差。PMML的诊断非常困难，基于多项临床、放射学和组织病理学标准。
一名61岁女性因咳嗽咳痰2个月、呼吸及咳嗽时诱发胸痛入院。胸部计算机断层扫描（CT）显示右肺中叶有一个巨大实性肿瘤。在B超引导下对右肺病变进行穿刺活检，并进行免疫组化检测。
通过B超引导下对右肺病变进行穿刺活检，组织病理学确诊为PMML。
患者拒绝接受手术、辅助化疗或放疗。
诊断后6个月患者死亡。
PMML的临床表现和影像学特征不具有特异性，与较常见的原发性支气管肺癌无差异。此外，根据其组织学和免疫组化无法与其他形式的原发性黑色素瘤相鉴别。首选治疗方法是积极的手术方法，联合放疗、化疗和免疫治疗。
