Lefrancq T, Badoual C, Body G, Machet M C, Perrotin F, Lhuintre Y
Laboratoire d'Anatomie Pathologique, Hôpital Bretonneau, Tours.
Ann Pathol. 1998 Jul;18(3):203-5.
We report a case of melanoma of the female urethra, recurring on the vulva as a desmoplastic invasive melanoma. The urethral tumor was an unclassifiable melanoma with an invasive epithelioid, and an intraepidermal atypical melanocytic component. The desmoplastic recidive was made of intersecting fascicles of spindled, moderately atypical cells, scattered over a dense collagenous matrix. Tumor cells were immunoreactive for S100 protein and vimentin, negative for HMB45. The morphological and immunophenotypic differences with the initial tumor, the absence of melanocytic dysplasia within the overlying epidermis, could lead to a misinterpretation of this lesion as a fibrous scar or a fibrohistiocytic tumor. Desmoplastic melanoma shares many homologies with acrolentiginous and mucous membrane melanoma and could occur more frequently on the genitourinary tract than it is generally assumed.
我们报告一例女性尿道黑色素瘤,在外阴复发为促纤维增生性浸润性黑色素瘤。尿道肿瘤为无法分类的黑色素瘤,具有浸润性上皮样成分及表皮内非典型黑素细胞成分。促纤维增生性复发灶由相互交织的梭形、中度非典型细胞束组成,散在于致密的胶原基质中。肿瘤细胞对S100蛋白和波形蛋白呈免疫反应,对HMB45呈阴性。与初始肿瘤在形态学和免疫表型上的差异,以及上方表皮内不存在黑素细胞发育异常,可能导致将此病变误诊为纤维瘢痕或纤维组织细胞瘤。促纤维增生性黑色素瘤与肢端雀斑样和黏膜黑色素瘤有许多同源性,且在泌尿生殖道的发生频率可能比一般认为的更高。