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目的:探讨转移性恶性黑色素瘤细针吸取细胞学形态特点,提高诊断和鉴别诊断的能力,以防漏诊。方法:选取原发灶已被病理组织学证实,并且淋巴结穿刺已做细胞块的恶性黑色素瘤患者26例,进行光镜观察细胞形态学特征,并用细胞块做免疫细胞化学染色标记。结果:26例转移性恶性黑色素瘤中,细针吸取细胞学对恶性肿瘤诊断准确率达100%,20例黑色素颗粒比较明显,细胞学直接诊断为恶性黑色素瘤,6例无色素及色素很少,其中4例以上皮样细胞为主,细胞学诊断为腺癌,2例细胞呈多形性以梭形细胞为主,诊断为多形性肉瘤。细针吸取细胞学检查诊断恶性黑色素瘤的准确率达78%。肿瘤细胞HMB45,S-100均阳性表达。结论:转移性恶性黑色素瘤的细胞形态学变化有显著的多样性,细针吸取细胞学对淋巴结转移无色素的恶性黑色素瘤诊断比较困难,利用细胞块进行免疫细胞化学染色,再结合临床资料,能大大提高转移性恶性黑色素瘤诊断准确率。
Objective: To investigate the morphological characteristics of fine needle aspiration cytology in metastatic malignant melanoma and to improve the ability of diagnosis and differential diagnosis to prevent misdiagnosis. Methods: Twenty - six malignant melanoma patients whose primary tumor had been confirmed by histopathology and had lymph node puncture had been treated with light microscope. Morphological characteristics of the cells were observed by immunocytochemical staining. Results: 26 cases of metastatic malignant melanoma, fine needle aspiration cytology accuracy of diagnosis of malignant tumors was 100%, 20 cases of melanin particles more obvious, cytological diagnosis of malignant melanoma, 6 cases of few pigment and pigment , Of which 4 cases of epithelial-like cells, cytological diagnosis of adenocarcinoma, 2 cases were pleomorphic spindle cells, the diagnosis of pleomorphic sarcoma. Fine needle aspiration cytology diagnosis of malignant melanoma accuracy rate of 78%. Tumor cells were positive for HMB45 and S-100. Conclusion: There are significant morphological changes in metastatic malignant melanoma. Fine needle aspiration cytology is more difficult to diagnose lymphatic metastasis of non-pigmented malignant melanoma. Immunocytochemical staining with cell mass, combined with clinical data, Can greatly improve the diagnostic accuracy of metastatic malignant melanoma.