Pigmented epithelioid melanocytoma

病理 医学 解剖 结核(地质) 蓝痣 真皮 网状真皮 病变 核异型性 真皮乳头状 异型性 黑色素瘤 生物 免疫组织化学 癌症研究 古生物学
作者
Jon R. Ward,Stephen Brady,Hiroomi Tada,Nikki Levin
出处
期刊:International Journal of Dermatology [Wiley]
卷期号:45 (12): 1403-1405 被引量:202
标识
DOI:10.1111/j.1365-4632.2006.02883.x
摘要

A 16-year-old Hispanic male presented with a nontender purple nodule on the right shoulder that had been present for 1 year. There was no personal or family history of skin cancer. He had no significant past medical history. Physical examination revealed a 10 mm × 5 mm, firm, dark purple nodule on the right anterior shoulder (Fig. 1). The surface was not eroded or crusted. The nodule was not attached to underlying structures. A deep shave excision was performed. Figure 1Open in figure viewerPowerPoint Clinical photograph of tumor of the right anterior shoulder Microscopic examination showed a polypoid tumor composed of heavily pigmented epithelioid melanocytes and melanophages with collagenous stroma (2, 3). Clusters of tumor cells were seen within the papillary dermis to lie in close apposition to the epidermis, which was variably hyperplastic and attenuated, but the lesion was predominantly dermal with only occasional atypical melanocytes disposed singly along the basal layer. The lesion appeared well circumscribed and, although quite thick at 3.42 mm, extended only superficially into the reticular dermis, the thickness being largely the result of protuberant growth. The nuclear detail was obscured by the copious melanin, and a bleached preparation was also examined. These sections revealed only mild cellular atypia, with round nuclear contours, open chromatin with peripheral margination, and a single distinct but small nucleolus; cytoplasm was abundant and no mitotic figures were identified. Ulceration, significant host lymphocyte response, lymphovascular invasion, and microsatellitosis were also absent. The diagnosis of animal (equine)-type melanoma was favored over other pigmented nevomelanocytic lesions, including cellular blue nevus, blue nevus with hypercellularity, and regressive tumoral melanosis. Figure 2Open in figure viewerPowerPoint Low-power histopathology of biopsy specimen (hematoxylin and eosin, ×10) Figure 3Open in figure viewerPowerPoint High-power histopathology of biopsy specimen (hematoxylin and eosin, ×100) Complete physical examination performed at the next follow-up visit revealed no lymphadenopathy or organomegaly. Serum lactate dehydrogenase and chest radiographs were normal. The patient underwent lymphoscintigraphy (Fig. 4) followed by wide local excision (2 cm margins), intraoperative lymphatic mapping, and sentinel lymph node biopsy (Fig. 5) 3 weeks after the initial biopsy. Three sentinel lymph nodes were identified in the right axilla and excised. All were grossly negative for tumor. Microscopic examination, however, showed two of the nodes to harbor subcapsular and intraparenchymal tumor deposits (Fig. 6), which were immunoreactive for S-100 protein and Mart-1. Computed tomography scans of the chest, abdomen, and pelvis did not demonstrate metastatic disease. Complete axillary lymph node dissection was recommended, but the patient and his family declined. At 6 months after the patient's initial diagnosis, he was free of any overt metastatic disease. Figure 4Open in figure viewerPowerPoint Lymphoscintigraphy Figure 5Open in figure viewerPowerPoint Sentinel lymph node (in vivo) Figure 6Open in figure viewerPowerPoint Sentinel lymph node (hematoxylin and eosin, ×25)
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
念初完成签到 ,获得积分10
1秒前
澡雪发布了新的文献求助10
2秒前
2秒前
魏为维发布了新的文献求助10
3秒前
搜集达人应助欣欣子采纳,获得10
4秒前
追寻书雁完成签到 ,获得积分10
5秒前
8秒前
tianmeiling完成签到 ,获得积分10
9秒前
天天快乐应助魏为维采纳,获得10
10秒前
LAVINE完成签到 ,获得积分10
10秒前
搜集达人应助儒雅致远采纳,获得30
10秒前
11秒前
12秒前
13秒前
影子发布了新的文献求助10
14秒前
可爱思山发布了新的文献求助40
14秒前
16秒前
白露完成签到 ,获得积分10
17秒前
香蕉觅云应助初之采纳,获得10
18秒前
liars发布了新的文献求助10
18秒前
量子星尘发布了新的文献求助10
19秒前
fei完成签到,获得积分10
20秒前
共享精神应助孙成成采纳,获得10
20秒前
20秒前
kjz发布了新的文献求助30
21秒前
不要讨好十三完成签到,获得积分10
22秒前
23秒前
阿达完成签到,获得积分20
23秒前
科研通AI2S应助科研通管家采纳,获得10
23秒前
搜集达人应助科研通管家采纳,获得10
23秒前
Owen应助科研通管家采纳,获得10
23秒前
23秒前
上官若男应助科研通管家采纳,获得10
23秒前
所所应助科研通管家采纳,获得10
24秒前
NexusExplorer应助科研通管家采纳,获得10
24秒前
深情安青应助科研通管家采纳,获得10
24秒前
Ava应助科研通管家采纳,获得10
24秒前
arabidopsis应助科研通管家采纳,获得10
24秒前
科研通AI2S应助科研通管家采纳,获得10
24秒前
24秒前
高分求助中
A new approach to the extrapolation of accelerated life test data 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 700
ACSM’s Guidelines for Exercise Testing and Prescription, 12th edition 500
Nucleophilic substitution in azasydnone-modified dinitroanisoles 500
不知道标题是什么 500
Indomethacinのヒトにおける経皮吸収 400
Phylogenetic study of the order Polydesmida (Myriapoda: Diplopoda) 370
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 3975543
求助须知:如何正确求助?哪些是违规求助? 3519971
关于积分的说明 11200248
捐赠科研通 3256311
什么是DOI,文献DOI怎么找? 1798213
邀请新用户注册赠送积分活动 877446
科研通“疑难数据库(出版商)”最低求助积分说明 806338