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[小恶性黑色素瘤的落射荧光显微镜特征]

[Epiluminescence microscopic characteristics of small malignant melanoma].

作者信息

Schulz H

出版信息

Hautarzt. 1997 Dec;48(12):904-9. doi: 10.1007/s001050050683.

Abstract

17% of malignant melanomas (n = 100) investigated in a dermatologic practice were less than 6 mm in maximal diameter (median diameter: 4.0 +/- 0.9 mm). The median age of the 17 patients at diagnosis of small-diameter melanomas was 42 years. The essential epiluminescence microscopic and histopathologic features of these small melanomas resembled those of larger lesions, although their clinical criteria differed from the classic ABCDs.6 (35.3%) of the small melanomas were were found to be in situ. This percentage was nearly similar to those in situ lesions within the group of melanomas of 6 mm in diameter or larger (38.3%). The remaining 11 small lesions were classified as invasive from Clark's level I to V, including all classic histogenetic types (superficial spreading, nodular, unclassified, desmoplastic). The median thickness of the small invasive melanomas was 0.76 +/- 0.23 mm. 7 small melanomas had apparent histologic remnants of a melanocytic nevus. Epiluminescence microscopic features of the melanomas were evaluated and statistically compared with those of 100 dysplastic nevi and 50 spindle cell nevi. The technique of epiluminescence microscopy allowed the identification of such malignant melanomas that could not be discerned by the naked eye or by a pocket-lens.

摘要

在一家皮肤科诊所调查的100例恶性黑色素瘤中,17%的最大直径小于6毫米(中位直径:4.0±0.9毫米)。这17例小直径黑色素瘤患者诊断时的中位年龄为42岁。这些小黑色素瘤的基本透照显微镜和组织病理学特征与较大病变相似,尽管其临床标准与经典的ABCD不同。6例(35.3%)小黑色素瘤为原位癌。该百分比与直径6毫米或更大的黑色素瘤组中原位病变的百分比几乎相似(38.3%)。其余11例小病变根据克拉克分级从I级到V级被分类为浸润性,包括所有经典组织发生类型(浅表扩散型、结节型、未分类型、促纤维增生型)。小浸润性黑色素瘤的中位厚度为0.76±0.23毫米。7例小黑色素瘤有明显的黑素细胞痣组织学残留。对黑色素瘤的透照显微镜特征进行了评估,并与100例发育异常痣和50例梭形细胞痣的特征进行了统计学比较。透照显微镜技术能够识别肉眼或袖珍透镜无法辨别的此类恶性黑色素瘤。

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