Tamura Daisuke, Maeda Daichi, Terada Yukihiro, Goto Akiteru
1 Akita University, Akita, Japan.
2 Osaka University, Osaka, Japan.
Int J Surg Pathol. 2019 Oct;27(7):773-777. doi: 10.1177/1066896919846395. Epub 2019 May 2.
Tattoo pigment migrates to regional lymph nodes, often causing acute or chronic lymphadenopathy. Past reports on tattoo lymphadenopathy are almost exclusively from Western countries. However, systemic distribution of tattoo pigment in lymph nodes has not been assessed in detail. In this article, we report a Japanese case of cervical adenocarcinoma, in which we successfully assessed the distribution of tattoo pigment deposition in pelvic and para-aortic lymph nodes. A 61-year-old woman with Japanese-style tattoos on both arms and her left thigh visited another clinic with postcoital bleeding. She was diagnosed with clinical stage 1B1 (cervical adenocarcinoma) and underwent radical hysterectomy and pelvic/para-aortic lymph node dissection. Histopathological examination revealed deposition of a black pigment in multiple lymph nodes. The pigment was more abundant in the left pelvic lymph nodes than in the para-aortic lymph nodes, a finding suggestive of pigment drainage from the tattoo on the left thigh. She remains free of disease more than 1 year after surgery. The diagnosis of tattoo lymphadenopathy is not easy when clinical information is lacking. The differential diagnoses include metastatic melanoma. Clinicians and pathologists should better recognize this phenomenon.
纹身色素会转移至区域淋巴结，常导致急性或慢性淋巴结病。以往关于纹身淋巴结病的报道几乎都来自西方国家。然而，纹身色素在淋巴结中的全身分布情况尚未得到详细评估。在本文中，我们报告了一例日本宫颈癌病例，在此病例中我们成功评估了纹身色素在盆腔和腹主动脉旁淋巴结中的沉积分布情况。一名61岁女性，双臂及左大腿有日式纹身，因性交后出血前往另一家诊所就诊。她被诊断为临床1B1期（宫颈腺癌），并接受了根治性子宫切除术及盆腔/腹主动脉旁淋巴结清扫术。组织病理学检查显示多个淋巴结中有黑色色素沉积。左侧盆腔淋巴结中的色素比腹主动脉旁淋巴结中的更丰富，这一发现提示色素从左大腿的纹身处引流。术后1年多她仍无疾病复发。当缺乏临床信息时，纹身淋巴结病的诊断并不容易。鉴别诊断包括转移性黑色素瘤。临床医生和病理医生应更好地认识这一现象。
