CAJ | 학술논문

目的：探讨肛管直肠恶性黑色素瘤的临床病理特征。方法收集7例肛管直肠恶性黑色素瘤的临床病理资料并随访，分析其临床和病理组织学特征和免疫表型。结果本例中包含女性5例，男性2例，年龄50～68岁，平均61岁。肿瘤位于直肠下端1例，齿线附近2例，肛管肛缘4例。该肿瘤组织结构和细胞形态有多样性。组织结构上主要为弥漫片状、巢状、腺泡状。细胞形态主要为上皮样、梭型细胞样、淋巴细胞样。免疫组织化学检测显示肿瘤细胞HMB45、S-100和vimentin 强阳性，LCA、CK和EMA均阴性，其中2例CEA灶性阳性，Ki-67 LI为20％～50％。结论肛管直肠恶性黑色素瘤是少见的恶性肿瘤，其特征性的组织形态、免疫表型有助于诊断和鉴别诊断。
목적：탐토항관직장악성흑색소류적림상병리특정。방법수집7례항관직장악성흑색소류적림상병리자료병수방，분석기림상화병리조직학특정화면역표형。결과본례중포함녀성5례，남성2례，년령50～68세，평균61세。종류위우직장하단1례，치선부근2례，항관항연4례。해종류조직결구화세포형태유다양성。조직결구상주요위미만편상、소상、선포상。세포형태주요위상피양、사형세포양、림파세포양。면역조직화학검측현시종류세포HMB45、S-100화vimentin 강양성，LCA、CK화EMA균음성，기중2례CEA조성양성，Ki-67 LI위20％～50％。결론항관직장악성흑색소류시소견적악성종류，기특정성적조직형태、면역표형유조우진단화감별진단。
Objective To investigate the clinical and pathological features of anorectal malignant melanoma ( AMM) .Methods The clinical pathological and follow-up data of 7 cases of anorectal malignant melanoma were collected.The clinical and histopathological features and immunophenotype were analyzed .Results Among the 7 cases, 5 cases were female, 2 cases were male, aged 50-68 years, the average was 61 years.The tumors located in the lower rectum in 1 cases, 2 cases of teeth near the line , 4 cases of anal anus .The structure and morphology of the cancer cells were diverse .The organizational structures were mainly diffuse , focal and acinar .The cellular morphologies were mainly epithelioid , spindle and lymphocyte like .And the results of IHC showed the expression of the following three markers, vimentin, S-100 and HMB45, were strongly positive in cancer cells.However, the expression of CK , EMA and LCA were negative .And 2 cases of CEA expression were positive , LI Ki-67 was 20%-50%.Conclusions Anorectal malignant melanoma is one kind of rare malignant tumor and its characteristic morphology , immunophenotype could be helpful for diagnosis and differential diagnosis .