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恶性黑色素性神经鞘瘤还是神经鞘膜黑色素瘤?

Malignant melanotic schwannoma or schwannian melanoma?

作者信息

Bosman C, Boldrini R, Corsi A

机构信息

III Cattedra di Anatomia e Istologia Patologica, Università La Sapienza, Roma, Italy.

出版信息

Tumori. 1995 May-Jun;81(3):208-12. doi: 10.1177/030089169508100312.

Abstract

A 43-year-old man underwent surgical removal of L4-L5 nerve root tumor which bulged to the extra and intradural spaces and extended as a dumbbell through the intervertebral foramen. Histological examination showed pleomorphic tumor cells with heavy melanin pigmentation. Most of the tumor cells were immunohistochemically positive for vimentin, S-100 protein and HMB-45 antigen; basic myelin protein was detectable in single tumor cells. Electron-microscopy revealed melanosomes in different stages of differentiation and some characteristics of Schwann cells, such as redundant basal lamina production. Taken together the tumor showed features of histological malignancy and incomplete schwannian differentiation with considerable overlap between melanoma and malignant melanotic schwannoma.

摘要

一名43岁男性接受了L4-L5神经根肿瘤切除术,该肿瘤向硬膜外和硬膜内间隙突出,并呈哑铃状穿过椎间孔延伸。组织学检查显示肿瘤细胞多形性,伴有大量黑色素沉着。大多数肿瘤细胞波形蛋白、S-100蛋白和HMB-45抗原免疫组化呈阳性;单个肿瘤细胞中可检测到碱性髓磷脂蛋白。电子显微镜检查发现处于不同分化阶段的黑素小体以及施万细胞的一些特征,如基底膜生成过多。综合来看,该肿瘤表现出组织学恶性特征以及不完全的施万细胞分化,黑色素瘤和恶性黑色素性施万瘤之间有相当程度的重叠。

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