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恶性黑色素瘤中枢神经系统转移并不少见,文献报导占57％,但国内有关黑色素瘤脑脊液细胞学检查专题报导甚少。我所收治1例脑干转移性黑色素瘤患者,其脑脊液细胞学检查发现黑色素瘤细胞,与已往报导不同,该例黑色素瘤细胞中大部分为“白色形瘤细胞”。男,40岁。持续头痛伴左侧肢体无力进行性加重1月余,言语不清、饮水呛咳,4年前曾做背部皮肤黑色素瘤(恶变)切除术。经体查、CT、MRI;右侧桥脑占位病变,考虑为转移瘤或胶质瘤。脑脊液细胞学检查:发现黑色素瘤细胞占细胞分类的9％,呈散在分布。其中,典型黑色素瘤细胞仅占瘤细胞的20％,其大小为15—20μm,呈圆形和椭圆形,胞浆丰
Malignant melanoma central nervous system metastasis is not uncommon, the literature reported 57%, but the domestic special report on cytology of cerebrospinal fluid in melanoma rarely. I have received a case of brain stem metastatic melanoma in patients with cerebrospinal fluid cytology found that melanoma cells, and previously reported different from the case of melanoma cells in the majority of “white tumor cells.” Male, 40 years old. Continuous headache with left limb weakness progressive increase more than 1 month, unclear speech, drinking cough, 4 years ago to do back skin melanoma (malignant) resection. After investigation, CT, MRI; right pontine lesions, considered as metastases or glioma. Cytology of cerebrospinal fluid: melanoma cells accounted for 9% of the cell classification, was scattered. Among them, the typical melanoma cells accounted for only 20% of the tumor cells, the size of 15-20μm, was round and oval, cytoplasmic abundance