Adolf W, Widhalm G
Pathologisch-bakteriologisches Institut, Kaiserin-Elisabeth-Spitales, Wien, Osterreich.
Zentralbl Allg Pathol. 1988;134(3):251-7.
Histological studies were conducted into 352 primary malignant melanomas of the skin together with 4,003 associated and surgically removed lymph nodes at the Institute of Pathology and Bacteriology of Kaiserin-Elisabeth-Spital, between 1982 and 1987. Particular attention was given to micrometastases of regional lymph nodes. 27 lymph node micrometastases were recorded from 25 patients. Spots of melanin were also found in lymphatic tissue, but no tumour cells were detectable. There is no clinical aid by which micrometastases of lymph nodes might be possibly diagnosed, and, on principle, they are greatly accidental findings even for the pathohistologist. However, undetected lymph node micrometastases may have a deteriorating impact upon the prognosis of malignant melanoma. Complete microscopic elucidation of surgically removed lymph nodes, there fore, is absolutely essential. Capillaries are present in abundance deep inside lymph nodes, and from these points of departure tumour cells may enter into the blood flow and cause haematogenic metastases. That is why the prognostic importance attributed to histologically verified micrometastases is just as great as that attached to macrometastases.
1982年至1987年间，在凯撒琳 - 伊丽莎白医院病理与细菌学研究所，对352例原发性皮肤恶性黑色素瘤以及4003个与之相关且手术切除的淋巴结进行了组织学研究。特别关注区域淋巴结的微转移情况。记录了来自25例患者的27个淋巴结微转移。在淋巴组织中也发现了黑色素斑点，但未检测到肿瘤细胞。目前尚无临床手段可用于诊断淋巴结微转移，原则上，即使对于病理组织学家而言，它们大多也是偶然发现。然而，未被检测到的淋巴结微转移可能会对恶性黑色素瘤的预后产生不良影响。因此，对手术切除的淋巴结进行完整的显微镜检查绝对必要。淋巴结内部深处有大量毛细血管，肿瘤细胞可能从这些部位进入血流并导致血行转移。这就是为什么组织学证实的微转移与大转移在预后方面具有同等重要性的原因。
