| 赵星云,杨萍,钟剑波,吴黎明.妊娠期背部色素痣恶变1例[J].浙江中西医结合杂志,2022,32(1): |
| 妊娠期背部色素痣恶变1例 |
| Malignant transformation of pigmented nevus on the back with pregnancy: a case report |
| 投稿时间：2021-05-25 修订日期：2021-09-05 |
| DOI： |
| 中文关键词: 色素痣 恶性黑色素瘤 妊娠 |
| 英文关键词:Pigmented nevus Malignant melanoma Pregnancy |
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| 中文摘要: |
| 报道1例妊娠期背部色素痣恶变患者。患者女，35岁，因背部黑色皮疹35年，逐渐隆起半年就诊。既往体健，妊娠35周。查体：背部可见约1cmx0.5cm椭圆形黑斑，黑斑表面有约小指头大小红色赘生物。皮肤镜：色素分布不均，可见蓝白结构，可见树枝状毛细血管。皮肤组织病理：真皮内见肿瘤结节，细胞呈中度异型性，核仁明显，可见核分裂象（7个/10HPF），部分向上侵犯表皮，浸润深度5mm。免疫组化：S-100(+)、HMB45(+)、Melan-A(+)、CyclinD1(+)、P53(+)、Ki67(+)、CK(-)。诊断：皮肤恶性黑色素瘤。治疗：先于我院皮肤科行皮肤肿物切除术，术后病理提示恶性黑色素瘤，基底及边缘未累及。后为进一步治疗就诊于浙江省肿瘤医院，行肿物边缘扩大切除术+前哨淋巴结活检，术后病理：肿瘤边缘皮肤组织病理未见肿瘤细胞，前哨淋巴结活检未见转移；术后予重组人白细胞介素-2 200万IU 皮下注射 QOD 共1月。半年后随访皮疹无复发。 |
| 英文摘要: |
| We describe a case of Malignant transformation of pigmented nevus on the back with pregnancy. A 35-year-old female presented with dorsal black papula, gradually swelling for half a year. Dermatology examination showed a oval black macula on the back, with a little finger sized red neoplasm on the surface, without ulceration and exudation. Dermoscopy examination showed uneven pigment distribution, blue-white structure and dendritic capillaries. Histopathological examination showed tumor nodules in the dermis, the cells were moderately atypia, nucleoli were obvious, and mitotic figures (7/10HPF) , part of which invades the epidermis upward, and the depth of invasion is 5mm. Immunohistochemistry examination showed S-100(+), HMB45(+), Melan-A(+), CyclinD1(+), P53(+), Ki67(+), CK(-). The diagnosis of cutaneous malignant melanoma was made. Treatment with expanded surgical resection and sentinel lymph node biopsy. IL-2 2 million IU QOD was injected subcutaneously after the operation, which is still being followed up. |
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