关键词：肛门；直肠；黑色素瘤；恶性；误诊
【摘要】目的分析肛管直肠恶性黑色素瘤临床及病理误诊的原因，探讨避免误诊的办法。方法对15例肛管直肠恶性黑色素瘤进行回顾性分析和免疫组化观察。结果临床误诊率为867%(13/15)。其中误诊为良性病变占667%(10/15)，误诊为痔或痔伴有肛周脓肿7例、息肉2例及慢性炎症1例；3例误诊为肛管直肠癌。延误诊治时间3个月至1年。活检病理误诊率为533%(8/15)，其中误诊为低分化腺癌6例，平滑肌肉瘤、类癌各1例。5例无色素性恶性黑色素瘤全部误诊。结论肛管直肠恶性黑色素瘤临床误诊率高，病理活检难以准确分型。临床和病理医生应密切配合，作直肠指诊，及时活检；对病理标本多作切片，仔细寻找黑色素颗粒并对可疑标本进行免疫组织化学检查，有助明确诊断。
Clinicopathological analysis formisdiagnosis of anorectal malignant melanoma
PEI Suli, PAN Hu, MA Jie, et al
(Department of Pathology, Henan Tumor Hospital, Zhengzhou 450003, China)
【Abstract】 Objective To analyze the causes of clinical andpathological misdiagnosis of anorectal malignant melanoma and investigate how to avoidsuch misdiagnosis.Methods Clinical and pathological data,including immunohistochemicalstaining of 15 cases with anorectal malignant melanoma were analyzedretrospectively.Results Clinical misdiagnosis rate was 86 7% (13/15), of which 5cases were misdiagnosed as anorectal cancers and 10 cases as benign diseases,including 7as hemorrhoids accompanied by anal abscess or not,2 as polypus,one as chronicinflammation.The correct diagnosis and therapy were delayed from three months to oneyear.Misdiagnosis rate of pathological biopsy was 53 3% (8/15)including 6 casesmisdiagnosed as poor differentiated adenocarcinoma,one as leiomyosarcoma and 1 ascarcinoid.All 5 cases of malignant amelanotic melanoma were misdiagnosed.ConclusionsBecause of high clinical misdiagnosis rate and difficulty to make diagnosis ofhistological type by pathological biopsy,it is important for clinical surgeons andpathological experts to cooperate closely,and to perform digital examination and biopsy intime.It is helpful to make a correct diagnosis that more slides and melanotic pigmentgranules should be examined carefully,and suspected samples should receiveimmunohistochemical assay.
......
您现在查看是摘要页，全文长 10328 字符。