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一百多年以来,最重要的鉴别良恶性肿瘤的诊断标准被认为是有无细胞核的异形性。许多著名的病理学家均认为细胞核的特征是鉴别恶性黑素瘤(MM)和黑素细胞痣的主要诊断标准。但近二十年来,作者逐渐得出这样的结论,即常规病理的良恶性肿瘤的鉴别更依赖于结构模式的特征,即所谓“轮廓”(Silhouette),而不是细胞学的改变(见附表)。MM与发育不良性痣细胞痣,特别是Spitz痣的鉴别也证实了这一理论。在Spitz痣中常有明显的核异形性及
For more than one hundred years, the most important diagnostic criteria for differentiating between benign and malignant tumors are thought to be the presence or absence of nuclear heterogeneity. Many famous pathologists believe that the characteristics of the nucleus are the main diagnostic criteria for distinguishing between malignant melanoma (MM) and melanocytes. But in the past two decades, the authors have come to the conclusion that the identification of benign and malignant tumors of routine pathology is more dependent on the characteristics of the structural model, the so-called “silhouette” rather than the cytological change (see table). ). The identification of MM with dysplastic nevi, especially Spitz, also confirms this theory. In Spitz, there is often obvious nuclear heterogeneity and