Søndergaard K
Virchows Arch A Pathol Anat Histopathol. 1983;401(3):333-43. doi: 10.1007/BF00734849.
Primary cutaneous malignant melanomas are generally divided into 3 separate clinico-pathological variants, lentigo maligna melanoma (LMM), superficial spreading melanoma (SSM), and nodular melanoma (NM). Recently an additional variant, acral lentiginous melanoma (ALM), has been defined, occurring on acral regions, defined as plantar, palmar, and sub-/parungual areas. Histological examination of 86 primary melanomas on acral regions revealed 24 (28%) acral lentiginous melanomas (ALM), 23 (27%) superficial spreading melanomas (SSM), 18 (21%) nodular melanomas (NM), and 21 (24%) unclassifiable melanomas. No LMM was seen. The prognosis was found to be the same in patients with SSM and ALM. However, by correlating histological type with frequency of antecedent nevus, duration of melanoma and dominant invasive tumor cell, it was demonstrated that histologically typical ALM differed from histologically typical SSM by their infrequent origin from antecedent nevi, their lower local growth rate, and their more frequent content of spindle cells. These findings support ALM as a valid melanoma subtype only when clearly defined histologically.
原发性皮肤恶性黑色素瘤通常分为3种不同的临床病理类型，即恶性雀斑样痣黑色素瘤（LMM）、浅表扩散性黑色素瘤（SSM）和结节性黑色素瘤（NM）。最近又定义了一种新的类型，肢端雀斑样痣黑色素瘤（ALM），发生于肢端部位，定义为足底、手掌以及甲下/甲周区域。对86例肢端原发性黑色素瘤进行组织学检查，结果显示有24例（28%）为肢端雀斑样痣黑色素瘤（ALM），23例（27%）为浅表扩散性黑色素瘤（SSM），18例（21%）为结节性黑色素瘤（NM），21例（24%）为无法分类的黑色素瘤。未发现恶性雀斑样痣黑色素瘤（LMM）。研究发现，浅表扩散性黑色素瘤（SSM）患者和肢端雀斑样痣黑色素瘤（ALM）患者的预后相同。然而，通过将组织学类型与既往痣的发生率、黑色素瘤的病程以及主要侵袭性肿瘤细胞进行关联分析，结果表明，组织学典型的肢端雀斑样痣黑色素瘤（ALM）与组织学典型的浅表扩散性黑色素瘤（SSM）不同，前者很少起源于既往痣，局部生长速度较慢，且梭形细胞含量较高。这些发现支持只有在组织学上明确界定的情况下，肢端雀斑样痣黑色素瘤（ALM）才是一种有效的黑色素瘤亚型。
