CAJ | 학술논문

目的：探讨肺转移性恶性黑色素瘤误诊的原因。方法对1例肺转移性恶性黑色素瘤误诊为肺透明细胞瘤作回顾性分析。结果肿瘤细胞呈巢状分布，胞浆透明或粉染，间质有薄壁的窦状血管，免疫组化染色结果显示：瘤细胞S-100、HMB45、Melan-A均阳性，与肺透明细胞瘤的组织学改变及免疫组化表型极为相似。由于患者曾有皮肤背部色素痣的切除史，且现发现原皮肤活检处存在肿瘤原发灶，应诊断为肺转移性恶性黑色素瘤。结论恶性黑色素瘤的临床特点多样，组织学形态复杂，诊断时应仔细观察病理切片，同时详细了解临床病史，并结合临床相关辅助检查，以减少误诊。
목적：탐토폐전이성악성흑색소류오진적원인。방법대1례폐전이성악성흑색소류오진위폐투명세포류작회고성분석。결과종류세포정소상분포，포장투명혹분염，간질유박벽적두상혈관，면역조화염색결과현시：류세포S-100、HMB45、Melan-A균양성，여폐투명세포류적조직학개변급면역조화표형겁위상사。유우환자증유피부배부색소지적절제사，차현발현원피부활검처존재종류원발조，응진단위폐전이성악성흑색소류。결론악성흑색소류적림상특점다양，조직학형태복잡，진단시응자세관찰병리절편，동시상세료해림상병사，병결합림상상관보조검사，이감소오진。
ObjectiveTo investigate the reason of pulmonary metastatic malignant melanoma misdiagnosed as clear cell tumor.MethodsA retrospective analysis was made on 1 case of pulmonary metastatic malignant melanoma misdiagnosed as clear cell tumor.ResultsTumor cells were in nests distribution, the cytoplasm was clear or pink dyed, and mesenchyme contained thin-walled sinus veins. Immunohistochemical staining Results showed that tumor cells S-100, HMB45, and Melan-A were all positive, and they were similar with the histologic and immunohistochemical phenotypes of pulmonary clear cell tumor. Due to the previous skin pigment nevus resection on the back of the patient and primary tumor found in the same place, this patient should be diagnosed as pulmonary metastatic malignant melanoma.ConclusionThe clinical features of malignant melanoma are various and have complicated histological appearance. Pathological section should be carefully observed and clinical history of patients must be known before diagnosis. A combination with clinical related auxiliary examination is helpful for reducing misdiagnosis.