Paul E, Illig L
Arch Dermatol Res (1975). 1976 Aug 27;256(2):179-87. doi: 10.1007/BF00567363.
With fluorescence-histochemical methods (formalin-induced fluorescence), the different stadia of development of lentigo maligna (Morbus Dubreuih) and lentigo maligna melanoma were investigated. In this way, the special stadia can be clearly characterized using the fluorescence-microscope. In the earliest stadium of malignancy, only the pigment-cells of the basal part of the epidermis seem to be numerous. At this time, these cells are mainly arranged as palisades in the basal layer, and their strongest dendrites are usually directed towards the corneal layer. As the malignancy progresses, the pigment-cells are arranged in several layers in the basal epidermis. In this case, polymorphism of the cells is obvious and their dendrites spread in all directions. A further stadium shows pathological alterations resembling a lentigo with long rete ridges. The atypical cells cluster together into the so-called pseudonests, predominantly at the tips of these rete ridges. With the fluorescence-microscope, dendrites are seldom visible here. In the stadium of tumorous growth, all above-described alterations of the epidermis in lentigo maligna are no longer detectable. Malignant cells in the dermis, which form as a tumor mode, seldom show dendrites. These cells are mainly round or oval-shaped; at best there are some spindle cells in certain areas of the tumor. The epidermis covering the tumor node is infiltrated by some tumor cells but the characteristic alterations as described above for the various stadia of lentigo maligna are no longer visible. Even fluorescence-microscopically, a tumor node of lentigo maligna does not seem to be different from a primary nodular melanoma or a tumor node of a superficial spreading melanoma, if the flat parts of the tumors are not considered in the diagnosis.
采用荧光组织化学方法（福尔马林诱导荧光），对恶性雀斑样痣（杜布雷伊病）和恶性雀斑样痣黑色素瘤的不同发展阶段进行了研究。通过这种方式，利用荧光显微镜可以清晰地识别出各个特定阶段。在恶性病变的最早阶段，似乎只有表皮基底部的色素细胞数量增多。此时，这些细胞主要在基底层呈栅栏状排列，其最长的树突通常指向角质层。随着恶性病变的进展，色素细胞在表皮基底层排列成多层。在这种情况下，细胞的多形性明显，其树突向各个方向伸展。进一步的阶段显示出类似于具有长表皮嵴的雀斑样痣的病理改变。非典型细胞聚集形成所谓的假巢，主要位于这些表皮嵴的顶端。在荧光显微镜下，此处很少能看到树突。在肿瘤生长阶段，恶性雀斑样痣表皮的上述所有改变均不再可检测到。真皮中的恶性细胞以肿瘤形式形成，很少显示树突。这些细胞主要呈圆形或椭圆形；在肿瘤的某些区域最多有一些梭形细胞。覆盖肿瘤结节的表皮被一些肿瘤细胞浸润，但恶性雀斑样痣各个阶段所描述的特征性改变不再可见。即使在荧光显微镜下，如果在诊断中不考虑肿瘤的扁平部分，恶性雀斑样痣的肿瘤结节似乎与原发性结节性黑色素瘤或浅表扩散性黑色素瘤的肿瘤结节没有区别。
