McDonald J S, Miller R L, Wagner W, Giammara B
Head Neck Surg. 1983 Jan-Feb;5(3):257-62. doi: 10.1002/hed.2890050311.
Lentiginous melanomas may be classified clinicopathologically as either lentigo maligna melanomas or acral lentiginous melanomas. Lentigo maligna melanoma is generally characterized by its slow rate of growth, lateness of metastasis, and relatively good prognosis. Acral lentiginous melanoma, while demonstrating a radial growth phase which is histologically similar to that of lentigo maligna, appears biologically more similar to superficially spreading malignant melanoma once the vertical growth phase supervenes. Mucous membrane melanomas with lentiginous characteristics are likely to be aggressive lesions with a marked propensity for metastasis and a uniformly poor prognosis, much like the acral lentiginous type of melanoma. It would seem, therefore, that superficial melanomas of the oral mucous membranes with a lentiginous pattern should best be termed acral lentiginous melanomas instead of lentigo maligna melanomas so as to more accurately predict their true biologic potential. An amelanotic case is presented which we believe illustrates this point.
雀斑样痣型黑色素瘤在临床病理上可分为恶性雀斑样痣型黑色素瘤或肢端雀斑样痣型黑色素瘤。恶性雀斑样痣型黑色素瘤通常具有生长缓慢、转移较晚和预后相对较好的特点。肢端雀斑样痣型黑色素瘤虽然有一个组织学上与恶性雀斑样痣相似的放射状生长期，但一旦进入垂直生长期，其生物学行为似乎更类似于浅表扩散型恶性黑色素瘤。具有雀斑样痣特征的黏膜黑色素瘤很可能是侵袭性病变，有明显的转移倾向且预后普遍较差，很像肢端雀斑样痣型黑色素瘤。因此，口腔黏膜具有雀斑样痣形态的浅表黑色素瘤似乎最好称为肢端雀斑样痣型黑色素瘤，而非恶性雀斑样痣型黑色素瘤，以便更准确地预测其真正的生物学潜能。本文展示了一例无色素沉着病例，我们认为该病例说明了这一点。
