Malignant melanoma. A case of malignant melanoma as genesis of nevocellular nevus.
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概要
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A 39-year-old female presented with a rapidly enlarging and easily bleeding tumor on her right thigh. On physical examination, there was a 3×2.5cm, parallelogramatic, black and dark red tumor on the lateral portion of the right thigh. The tumor was radically excised with regional lymph nodes dissection, followed by receiving chemotherapy with DAV etc. Up to the present time, she has remained disease-free. Gross pathologically, the lesion consisted of a nodule and a flat-elevated part. Histopatho-logically, the nodule had central and bilateral portions. The former consisted of A-type-like cells similar to A-type of nevus cell nevus and B-type cells of the nevus cell nevus. There was gradual transition between them. The bilateral portions composed of highly atypical tumor cells showed expansive growth. The flat-elevated part consisted of A-type-like cells and spindle-shaped cells in the epidermis and the papillary dermis. Tumor cells of the regional lymph node metastasis had almost the same characteristics as those of A-type like cells. The tumor cells in local recurrence were mainly spindle-shaped.Immunohistochemistry showed common reactivity between A-type-like cells and tumor cells in the flat-elevated part, but the tumor cells in bilateral portion of the nodule had the characteristics different from those of A-type-like cells. These findings suggest that in this patient malignant melanoma arose from nevocytic cells in the dermis.
- 日本皮膚悪性腫瘍学会の論文
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