CAJ | 학술논문

目的：总结肝脏原发性恶性黑色素瘤的临床、影像学特征，提高本病的诊断水平。方法以原发性肝脏恶性黑色素瘤为关键词检索万方数据库1980～2014年间相关文献，总结肝脏原发性恶性黑色素瘤的临床、影像学特征。结果2000年以前我国无该病例报道，2000年以后报道15例。原发于肝脏的恶性黑色素瘤较为罕见，其临床表现及CT表现无明显特征。 MRI表现为T1和T2弛豫时间缩短，T1WI呈高信号，T2WI呈低信号。肝穿刺病理学检查可见异型细胞呈巢状分布，分化较差，大量黑色素沉积。免疫组化结果显示HMB45（＋）、S-100（＋）、CK （－）。结论肝脏原发性恶性黑色素瘤临床缺乏特异性症状，主要表现为上腹部胀满、疼痛和肝功异常等。 MRI是诊断恶性黑色素瘤的最佳影像学检查方法，表现为T1和T2弛豫时间缩短，T1WI呈高信号，T2WI呈低信号。
목적：총결간장원발성악성흑색소류적림상、영상학특정，제고본병적진단수평。방법이원발성간장악성흑색소류위관건사검색만방수거고1980～2014년간상관문헌，총결간장원발성악성흑색소류적림상、영상학특정。결과2000년이전아국무해병례보도，2000년이후보도15례。원발우간장적악성흑색소류교위한견，기림상표현급CT표현무명현특정。 MRI표현위T1화T2이예시간축단，T1WI정고신호，T2WI정저신호。간천자병이학검사가견이형세포정소상분포，분화교차，대량흑색소침적。면역조화결과현시HMB45（＋）、S-100（＋）、CK （－）。결론간장원발성악성흑색소류림상결핍특이성증상，주요표현위상복부창만、동통화간공이상등。 MRI시진단악성흑색소류적최가영상학검사방법，표현위T1화T2이예시간축단，T1WI정고신호，T2WI정저신호。
Objective To summarize the clinical and imaging features of primary malignant melanoma of liver in order to raise the diagnosis of this disease.Methods We took"Primary liver malignant melanoma"as the keywords to search the literatures from 1980 to 2014 in the Wanfang database and summarized the clinical and imaging features of primary malignant melanoma of liver.Results There was no case reported in China before 2000, and 15 cases reported after 2000.Primary malignant melanoma is relatively rare in the liver.Its clinical manifestations and CT show no obvious characteristics.MRI performance has certain characteristics:T1 and T2 relaxation time shortens, T1WI shows high signal and T2WI shows low sig-nal.Liver biopsy:there is nest-like distribution of heterocyst, poor differentiation and a large amount of melanin deposition. Immunohistochemical:HMB45 (+) , S-100 (+) and CK (-) .Conclusions The clinical features of primary malignant melanoma of liver lack of special clinical symptoms, and the main manifestations are upper abdominal distension, pain and abnormal liver function and other symptoms.MRI is the best imaging examination method in the diagnosis of malignant mela-noma, which shows that T1 and T2 relaxation time is shortened, T1WI has high signal and T2WI has low signal.