Tucker M A, Misfeldt D, Coleman C N, Clark W H, Rosenberg S A
Ann Intern Med. 1985 Jan;102(1):37-41. doi: 10.7326/0003-4819-102-1-37.
Eight cutaneous malignant melanomas occurred in 6 of 1405 patients with Hodgkin's disease, although the expected incidence rate was 0.77 (relative risk, 8; 95% confidence interval, 3 to 17). One melanoma was a thin, level II lesion less than 0.76 mm thick; the rest were mostly bulky, deeply invasive lesions despite close clinical surveillance. The melanomas spread aggressively; 3 of 6 patients died within 1 to 3 years. Two of the six patients developed a second primary malignant melanoma 1 year after the first. Two of six patients had biopsy-proven dysplastic nevus syndrome, a known precursor to cutaneous malignant melanoma, and an additional 3 patients had clinical evidence of dysplastic nevus syndrome. Histologically, the malignant melanomas showed a sparse inflammatory infiltrate, an abnormal host response seen previously in cutaneous melanomas developing in immunosuppressed patients. Dysplastic nevi may identify patients at highest risk who require modified medical management.
在1405例霍奇金病患者中，有6例出现了8例皮肤恶性黑色素瘤，尽管预期发病率为0.77（相对风险为8；95%置信区间为3至17）。其中1例黑色素瘤为厚度小于0.76 mm的薄的Ⅱ级病变；其余大多为体积较大、浸润较深的病变，尽管进行了密切的临床监测。这些黑色素瘤侵袭性强；6例患者中有3例在1至3年内死亡。6例患者中有2例在首次发病1年后发生了第二原发性恶性黑色素瘤。6例患者中有2例经活检证实患有发育异常痣综合征，这是皮肤恶性黑色素瘤已知的前驱病变，另外3例患者有发育异常痣综合征的临床证据。组织学上，恶性黑色素瘤显示炎症浸润稀疏，这是先前在免疫抑制患者发生的皮肤黑色素瘤中所见的异常宿主反应。发育异常痣可能识别出需要改进医疗管理的高危患者。
