Robert C, Schoenlaub P, Avril M F, Lok C, Grosshans E, Valeyre D, Bourgeois C, Pinquier L, Dubertret L, Guillaume J C
Service de Dermatologie, Hôpital Saint Louis, Paris, France.
Br J Dermatol. 1997 Nov;137(5):787-92.
Sarcoidosis or granulomatous reactions have rarely been reported in association with malignant melanoma (MM). We describe seven patients who presented with both granulomatous disease and MM, and discuss the physiopathological and prognostic significance of this association. In three patients, the granulomatosis was diagnosed as true sarcoidosis and in one patient, as tumour-associated granuloma. In three cases, designated here as atypical tumour-associated granulomatoses, the presence of clear-cut pulmonary granulomatous nodules was typical neither for sarcoidosis nor for tumour-associated granuloma and was highly suggestive of melanoma metastases. Mediastinal lymphadenopathy was present in every patient. In all seven patients, the question of mediastinal or pulmonary involvement or relapse of the MM was raised, but could be confirmed in only one patient. MM can be associated with granulomatous disease. Knowledge of this association has implications in the management of patients with MM.
结节病或肉芽肿反应与恶性黑色素瘤（MM）相关的报道极为罕见。我们描述了7例同时患有肉芽肿性疾病和MM的患者，并讨论了这种关联的生理病理学及预后意义。3例患者的肉芽肿病被诊断为真性结节病，1例患者被诊断为肿瘤相关性肉芽肿。在3例被认定为非典型肿瘤相关性肉芽肿的病例中，明确的肺部肉芽肿结节既不符合结节病的典型表现，也不符合肿瘤相关性肉芽肿的典型表现，高度提示为黑色素瘤转移。所有患者均存在纵隔淋巴结肿大。在所有7例患者中，均提出了MM纵隔或肺部受累或复发的问题，但仅在1例患者中得到证实。MM可与肉芽肿性疾病相关。了解这种关联对MM患者的管理具有重要意义。
