甲,恶性黑色素瘤,临床病理分析," /> 甲,恶性黑色素瘤,临床病理分析,"/> nail, malignant melanoma, clinicopathologic analysis,"/> 甲下恶性黑色素瘤28例临床病理分析

中国麻风皮肤病杂志 ›› 2024, Vol. 40 ›› Issue (3): 182-185.doi: 10.12144/zgmfskin202403182

• 论著 • 上一篇    下一篇

甲下恶性黑色素瘤28例临床病理分析

王建文1,2,陈学超1,2,周桂芝1,2,陈声利1,2,卢宪梅1,2,张雪燕1,2,张帆1,2,刘永霞1,2   

  1. 1山东第一医科大学附属皮肤病医院，山东济南，250022；2山东省皮肤病性病防治研究所，山东济南，250022
  • 出版日期:2024-03-15 发布日期:2024-02-27

Clinical and histopathological characters of 28 cases of subungual melanoma

WANG Jianwen1,2, CHEN Xuechao1,2, ZHOU Guizhi1,2, CHEN Shengli1,2, LU Xianmei1,2,  ZHANG Xueyan1,2, ZHANG Fan1,2, LIU Yongxia1,2   

  1. 1 Hospital for Skin Diseases, Shandong First Medical University, Jinan 250022, China;2 Shandong Provincial Institute of Dermatology and Venereology, Shandong Academy of Medical Sciences, Jinan 250022, China
  • Online:2024-03-15 Published:2024-02-27

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摘要： 目的：探讨原发甲下恶性黑色素瘤的临床病理特征。方法：回顾性分析2013年1月至2022年06月山东第一医科大学附属皮肤病医院病理科28例甲下恶性黑色素瘤的临床病理资料。结果：28例甲下恶性黑色素瘤中，男12例、女16例，平均年龄50岁，好发于拇指，临床表现为甲黑线、甲破坏等，黑线宽度均>3 mm,哈钦森征阳性9例；组织学类型主要为肢端雀斑样痣型，细胞组成主要为上皮样细胞，免疫组化SOX10比S100表达阳性率高；28例中随访16例，7例扩大切除，8例局部截肢治疗，1例化疗后死亡。12例失访。结论：甲下恶性黑色素瘤有不同于其他部位恶性黑色素瘤的临床病理学特点，临床与病理均易误诊。对于年龄大于50岁，临床表现为甲黑线，宽度>3 mm，哈钦森阳性的患者均应警惕甲下恶性黑色素瘤，应及时做病理检查。

关键词: 甲')">">甲, 恶性黑色素瘤, 临床病理分析

Abstract: Objective: To explore the clinicopathologic features of primary subungual malignant melanoma. Methods: The clinicopathologic and prognostic information of 28 cases of subnail malignant melanoma in our hospital from January 2013 to June 2022 were analyzed respectively. Results: Of 28 cases, 12 were male and 16 were female, the average age was 50 years old, and the lesions most occurred on the thumb, with clinical manifestations such as black line of the nail, nail destruction, etc. The width of the black line was greater than 3 mm, and 9 cases were positive for Hutchinson. The histological type was mainly of the limb freckle-like nevus type, and the cellular composition was mainly of epithelioid cells. The positivity rate of immunohistochemistry was higher in the expression of SOX10 than that of S100. Sixteen cases were followed up, including 7 cases were treated with extended resection, eight with local amputation, and one died after chemotherapy, and 12 cases were lost to follow up. Conclusion: Subungual malignant melanoma has different clinicopathologic characteristics from malignant melanoma in other parts of the body, and is easy to be misdiagnosed both clinically and pathologically. For patients who are older than 50 years old, with clinical manifestations of black nail lines, width >3mm, and Hutchinson's positivity should be alerted to subnail malignant melanoma, and pathological examination should be done in time.

Key words: nail')">">nail, malignant melanoma, clinicopathologic analysis