Nevus, Pigmented

痣,着色
  • 文章类型: Case Reports
    背景:迄今为止,只有有限数量的病例报告记录了医学文献中PNS和黑素细胞痣的同时发生.这项研究旨在报告一例罕见的后胸壁PNS与黑素细胞痣结合的病例。
    方法:一名46岁女性,在她的左上后胸壁上有一个长期的黑色病变,在演讲前的两个月里,这变得很痛苦。有一个痛苦,深蓝色,非红斑,左上后胸壁无触痛结节。基于患者对美容目的的渴望,在局部麻醉下,将病灶完全切除,初次闭合。组织病理学检查显示皮内黑素细胞痣伴毛发窦发炎。
    结论:与痣相关的后胸壁PNS的稀有性对临床医生提出了独特的诊断和治疗挑战。独特的解剖位置,不同于传统地区,而这两种情况之间的罕见关联可能会延迟准确诊断,并导致管理不善或干预不当.
    结论:后胸壁PNS是另一种非常罕见的非典型PNS。PNS和蓝痣之间的关联是一个令人着迷的医学发现,值得进一步研究。
    BACKGROUND: To date, only a limited number of case reports have documented the co-occurrence of PNS and melanocytic nevus in the medical literature. This study aims to report an exceptionally rare case of posterior chest wall PNS in conjunction with a melanocytic nevus.
    METHODS: A 46-year-old female presented with a long-standing black lesion on her left upper posterior chest wall, that had become painful in the two months prior to presentation. There was a painful, dark blue, non-erythematous, and non-tender nodule on the left upper posterior chest wall. Based on the patient\'s desire for cosmetic purposes, the lesion was excised totally with primary closure under local anaesthesia. Histopathological examination revealed intradermal melanocytic nevus with inflamed pilonidal sinus.
    CONCLUSIONS: The rarity of posterior chest wall PNS associated with nevi poses unique diagnostic and therapeutic challenges for clinicians. The distinct anatomical location, different from the conventional region, and the rare association between the two conditions may delay accurate diagnosis and result in mismanagement or inappropriate interventions.
    CONCLUSIONS: The posterior chest wall PNS is another type of atypical PNS that is extremely rare. The association between PNS and blue nevus is a fascinating medical finding that deserves further investigation.
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  • 文章类型: Case Reports
    在进行诊断性活检并随后切除逐渐扩大的红棕色结节后,一名11岁的女性从外部机构转诊,这表明球囊细胞痣具有严重的异型性与高度黑色素细胞瘤有关。在查看初始活检标本和分子数据后,我们认为该诊断与高度黑色素细胞瘤伴球囊细胞改变相一致,同时考虑到由于组织病理学和遗传异常而导致的球囊细胞黑色素瘤的可能性.在这个案例研究中,我们讨论了这个罕见的儿科病例的关键诊断考虑因素,并强调了黑色素细胞瘤和球囊细胞黑色素瘤的重要病理和临床特征。
    An 11-year-old female was referred from an outside institution after a diagnostic biopsy and subsequent excision of a progressively enlarging reddish-brown nodule demonstrated features concerning for a balloon cell nevus with severe atypia versus a high-grade melanocytoma. Upon review of the initial biopsy specimen and molecular data, we favored the diagnosis to be consistent with a high-grade melanocytoma with balloon cell changes while considering the possibility of balloon cell melanoma due to concerning histopathologic and genetic abnormalities. In this case study, we discuss critical diagnostic considerations in this rare pediatric case and highlight important pathologic and clinical features of melanocytomas and balloon cell melanoma.
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  • 文章类型: Journal Article
    痣是一种罕见的先天性错构瘤,其临床和组织病理学特征随青春期而变化。它与许多继发性肿瘤有关,其中大部分被认为来自卵泡生殖细胞。在这篇文章中,作者描述了总共3例黑素细胞痣和色斑痣的合并病例,以强调这一罕见的发现。
    UNASSIGNED: Nevus sebaceus is a rare congenital hamartoma with clinical and histopathological features that change with puberty. It has been associated with a number of secondary neoplasms, most of which are thought to derive from follicular germ cells. In this article, the authors describe a total of 3 cases of combined melanocytic nevus and nevus sebaceus to highlight this rare finding.
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  • 文章类型: Case Reports
    在患有先天性巨大黑素细胞痣的新生儿中,表现为睾丸旁阴囊肿块的非典型神经纤维瘤肿瘤很少见。早期仅报道了一例新生儿阴囊神经纤维瘤。我们报告了另一个病例及其管理。
    UNASSIGNED: Atypical neurofibromatous neoplasm with uncertain biologic potential presenting as a paratesticular scrotal mass in a neonate with congenital giant melanocytic nevus is rare. Only one such case of neonatal scrotal neurofibroma has been reported earlier. We report an additional case and its management.
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  • 文章类型: Case Reports
    暂无摘要。
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  • 文章类型: Case Reports
    背景:细胞蓝痣是一种罕见的脊柱肿瘤。
    方法:这里,我们介绍了一例24岁的男性,有2个月的右上肢和肩部麻木的病史。
    方法:颈椎和皮下组织侵袭性细胞蓝痣。
    方法:患者接受C4椎板切除术和部分C3和C5椎板切除术,以完全切除病变。组织病理学显示结节性肿瘤边界不清,由色素沉着的树突状细胞和色素沉着的梭形细胞组成。
    结果:随访3年无复发。
    结论:由于其特殊的细胞行为和稀有性,脊柱侵袭性细胞蓝痣可被错误诊断为脊髓脑膜黑素细胞瘤和脑膜黑色素瘤。因此,重要的是要了解其病理和临床特征,以避免过度治疗。
    BACKGROUND: Cellular blue nevus is an uncommon neoplasm in the spine.
    METHODS: Here, we present a case of a 24 years old male with a 2 months history of numbness in the right upper limb and shoulder.
    METHODS: Cervical spine and subcutaneous tissue invasive cellular blue nevus.
    METHODS: The patient underwent C4 laminectomy and partial C3 and C5 laminectomy for total resection of the lesion. Histopathology revealed a nodular tumor with unclear boundaries, which was composed of heavily pigmented dendritic cells and more pigmented spindle cells.
    RESULTS: There was no recurrence during 3 years follow-up.
    CONCLUSIONS: Invasive cellular blue nevus of the spine can be wrongly diagnosed as spinal meningeal melanocytoma and meningeal melanoma due to its special cell behavior and rarity. Therefore, it is important to understand its pathological and clinical characteristics to avoid over-treatment.
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  • 文章类型: Review
    恶性黑色素瘤,一种罕见的儿童皮肤癌,主要影响10岁以上的人。巨大的先天性痣,在大约1%的新生儿中发现,增加了风险。然而,在新生儿期诊断出的先前存在的巨大先天性痣引起的黑色素瘤非常罕见。我们介绍了一个新生儿先天性黑色素瘤的病例,结节生长在婴儿背上现有的痣上。审查了有关管理此类案件的文献。此案例强调了考虑先天性痣恶性转化的重要性及其管理中的挑战。由于报告的病例超过80年,很难提供关于生存和治疗选择的结论性发现.临床医生应报告结果,以开发新生儿黑色素瘤的管理算法。需要进一步的研究来加深对先天性巨大毛痣和相关黑色素瘤患者的病因和治疗的了解。
    Malignant melanoma, a rare skin cancer in children, primarily affects individuals over 10 years old. Giant congenital nevi, found in about 1% of newborns, increases the risk. However, the development of melanoma from a pre-existing giant congenital nevus diagnosed during the neonatal period is exceptionally rare. We present a case of congenital melanoma in a newborn, where nodules grew on an existing nevus on the baby\'s back. Literature on managing such cases was reviewed. This case highlights the importance of considering malignant transformation in congenital nevi and the challenges in their management. Due to limited reported cases over 80 years, conclusive findings on survival and treatment options are difficult to provide. Clinicians should report outcomes to develop a management algorithm for neonatal melanoma. Further studies are needed to enhance understanding of causes and treatment for patients with congenital giant hairy nevi and associated melanoma.
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  • 文章类型: Journal Article
    背景:S100A8是黑色素瘤相关表皮角质形成细胞中表达的黑色素瘤生物标志物,但它的诊断效用尚未与其他生物标志物相比,包括PRAME。
    目的:本病例对照研究比较了S100A8和PRAME免疫组织化学在黑色素瘤和痣鉴别诊断中的应用。
    方法:包括先前描述的209个黑色素瘤和痣的S100A8和PRAME双重免疫染色的队列。对于S100A8,使用先前报告的分数,其指示被染色的肿瘤相关表皮的比例(0=不确定;1=0-4%;2=5-25%;3=26-50%;4=51-75%;5>75%)。PRAMEIHC由至少两名审稿人进行审查,并分配了共识分数,评分指示肿瘤染色的比例(0=不确定;1=0%;2=1-50%;3>50%)。阳性测试被定义为>50%染色。
    结果:S100A8(0.833)和PRAME(0.874)的受试者工作特征曲线下面积彼此之间没有显着差异(p=0.22)。S100A8的诊断敏感性和特异性(95%CI)为42.4%(32.55%-52.77%)和98.2%(93.6%-99.8%),PRAME为79.8%(70.5%-87.2%)和87.3%(79.6%-92.9%),分别。需要S100A8和PRAMEIHC阳性的组合测试具有39.4%(29.7%-49.7%)的灵敏度和99.1%(95.0%-100.0%)的特异性。
    结论:S100A8和PRAME在黑色素瘤的诊断检查中具有实用性,使用此阈值时,S100A8更具体,PRAME更敏感。我们的发现表明,这两种免疫组织化学标记物可以有利地相互补充,以改善黑色素瘤的检测。
    BACKGROUND: S100A8 is a melanoma biomarker expressed in the melanoma-associated epidermal keratinocytes, but its diagnostic utility has not been compared with other biomarkers, including PRAME.
    OBJECTIVE: To compare the utility of S100A8 and PRAME immunohistochemistry (IHC) in the differential diagnosis of melanoma and naevi in a case-control study.
    METHODS: A previously described cohort of 209 melanomas (case samples) and naevi (control samples) dual-immunostained for S100A8 and PRAME were included. For S100A8, previously reported scores indicating the proportion of tumour-associated epidermis stained (0 = indeterminate; 1 = 0-4%; 2 = 5-25%; 3 = 26-50%; 4 = 51-75%; 5 = > 75%) were utilized. PRAME IHC was reviewed by at least two reviewers and a consensus score assigned, with score indicating the proportion of tumour stained (0 = indeterminate; 1 = 0%; 2 = 1-50%; 3 = > 50%). A positive test was defined as > 50% staining.
    RESULTS: The area under the receiver operating characteristic curves for S100A8 (0.833) and PRAME (0.874) were not significantly different from each other (P = 0.22). The diagnostic sensitivity and specificity were 42.4% [95% confidence interval (CI) 32.6-52.8%] and 98.2% (95% CI 93.6-99.8%) for S100A8, and 79.8% (95% CI 70.5-87.2%) and 87.3% (95% CI 79.6-92.9%) for PRAME, respectively. A combined test requiring both S100A8 and PRAME IHC positivity had a sensitivity of 39.4% (95% CI 29.7-49.7%) and specificity of 99.1% (95% CI 95.0-100.0%).
    CONCLUSIONS: S100A8 and PRAME have utility in the diagnostic workup of melanoma, with S100A8 being more specific and PRAME being more sensitive when using this threshold. Our findings suggest that these two immunohistochemical markers may favourably complement one another to improve the detection of melanoma.
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  • 文章类型: Review
    简介:黑色素瘤,由不受控制的黑素细胞增殖引起的恶性肿瘤,常见于皮肤,但能够影响皮肤外部位,在诊断的肿瘤实体中排名第五,是癌症死亡的重要原因,占皮肤癌死亡率的80%以上。遗传因素和紫外线辐射(UVR)暴露,来自自然和人工来源,是主要的风险因素。病例介绍:我们报道了一名25岁女性的病例,该女性患有许多色素痣,并且由于广泛的室内晒黑而发生了显着变化。皮肤病学检查和皮肤镜评估显示两个色素痣的非典型特征,导致手术切除。组织病理学和免疫组织化学分析证实了一个病灶中的复合痣和另一个病灶中的浅表扩散黑色素瘤,强调警惕随访和正确使用免疫组织化学的重要性。讨论:室内晒黑显着提高皮肤黑色素瘤的风险,在35岁之前开始将风险放大高达75%,尤其是年轻女性。风险随着会议的累积而升级,特别是超过480人,经历30次以上的个人面临32%的风险。UVR诱导DNA损伤,基因突变,和免疫抑制,有助于肿瘤发生。遗传因素,就像PTCHD2基因一样,可能会影响晒黑的依赖性。针对未成年人的立法已在全球范围内颁布,但仅具有部分效力。鞣制促进剂,虽然伴随着轻微的副作用,与高风险行为相关。此案突显了解决室内晒黑风险的紧迫性,强调有针对性的提高认识工作和立法改进。结论:总之,报道的病例强调了与室内晒黑相关的皮肤黑色素瘤风险增加,特别是在年轻女性和特定的社会人口群体中。尽管采取了立法措施,挑战依然存在,建议涉及相关影响者的在线活动的潜在功效,以提高认识并阻止人工晒黑。
    Introduction: Melanoma, a malignant tumor arising from uncontrolled melanocytic proliferation, commonly found in the skin but capable of affecting extracutaneous sites, ranks fifth among diagnosed oncological entities and is a significant cause of cancer deaths, constituting over 80% of skin cancer mortality. Genetic factors and ultraviolet radiation (UVR) exposure, from both natural and artificial sources, are the primary risk factors. Case Presentation: We reported the case of a 25-year-old female with numerous pigmented nevi and notable changes attributed to extensive indoor tanning sessions. Dermatological examinations and dermoscopic evaluations revealed atypical features in two pigmented nevi, leading to surgical excision. Histopathological and immunohistochemical analyses confirmed a compound nevus in one lesion and superficial spreading melanoma in the other, emphasizing the importance of vigilant follow-up and the correct use of immunohistochemistry. Discussion: Indoor tanning significantly elevates the cutaneous melanoma risk, with initiation before age 35 amplifying the risk by up to 75%, especially in young women. The risk escalates with cumulative sessions, particularly exceeding 480, and individuals undergoing over 30 sessions face a 32% higher risk. UVR induces DNA damage, genetic mutations, and immunosuppression, contributing to oncogenesis. Genetic factors, like the PTCHD2 gene, may influence the tanning dependency. Legislation targeting minors has been enacted globally but only with partial efficacy. Tanning accelerators, though associated with minor side effects, correlate with high-risk behaviors. The case underscores the urgency of addressing indoor tanning risks, emphasizing targeted awareness efforts and legislative improvements. Conclusions: In conclusion, the reported case highlights the increased risk of cutaneous melanoma linked to indoor tanning, particularly among young women and specific sociodemographic groups. Despite legislative measures, challenges persist, suggesting the potential efficacy of online campaigns involving relatable influencers to raise awareness and discourage artificial tanning.
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  • 文章类型: Review
    简介:源自中枢神经系统黑素细胞的原发性黑素细胞肿瘤很少见,发病率低,每年每1000万有0.7例。本研究的重点是原发性软脑膜黑素细胞瘤,强调他们的流行病学,临床特征,和诊断挑战。尽管他们的频率不高,这些肿瘤因其独特的特征和可能的局部复发而值得关注.病例报告:一名32岁女性出现晕厥和癫痫发作,导致发现两个最初被误认为是凸面脑膜瘤的左侧幕上病变。详细的影像显示脑膜瘤样特征,但是术中发现了意想不到的色素沉着过度病变。组织病理学检查,由免疫组织化学支持,证实原发性软脑膜黑色素细胞瘤。讨论了手术方法和后续处理。讨论:讨论强调了诊断原发性软脑膜黑素细胞瘤的挑战。治疗辩论,特别是关于辅助放疗,正在探索。复发风险强调了警惕后续行动的重要性,提倡以完全手术切除为主要方法。罕见的幕上病例增加了诊断的复杂性,需要多学科方法。这种情况下的见解有助于理解和管理原发性软脑膜黑色素细胞瘤,解决从更常见的肿瘤中区分的挑战,并促进正在进行的研究,以完善的诊断和优化的治疗。结论:本研究有助于了解原发性软脑膜黑素细胞瘤,突出了它们在幕上区域的稀有性。该案例强调了多学科方法的重要性,结合临床,放射学,和组织病理学专业知识的准确诊断和量身定制的管理。持续的研究对于完善治疗策略至关重要,提高预后精度,并改善患有这种罕见中枢神经系统肿瘤的个体的结局。
    Introduction: Primary melanocytic tumors originating from CNS melanocytes are rare, with a low incidence of 0.7 cases per 10 million annually. This study focuses on primary leptomeningeal melanocytomas, emphasizing their epidemiology, clinical characteristics, and diagnostic challenges. Despite their infrequency, these tumors warrant attention due to their unique features and potential for local recurrence. Case Report: A 32-year-old female presented with syncope and seizures, leading to the discovery of two left-sided supratentorial lesions initially misidentified as convexity meningiomas. Detailed imaging suggested meningioma-like features, but intraoperative findings revealed unexpected hyperpigmented lesions. Histopathological examination, supported by immunohistochemistry, confirmed primary leptomeningeal melanocytoma. The surgical approach and subsequent management are discussed. Discussion: The discussion emphasizes challenges in diagnosing primary leptomeningeal melanocytomas. Treatment debates, especially regarding adjuvant radiotherapy, are explored. Recurrence risks stress the importance of vigilant follow-up, advocating for complete surgical resection as the primary approach. The rarity of supratentorial cases adds complexity to diagnosis, necessitating a multidisciplinary approach. Insights from this case contribute to understanding and managing primary leptomeningeal melanocytomas, addressing challenges in differentiation from more common tumors and prompting ongoing research for refined diagnostics and optimized treatments. Conclusion: This study contributes insights into primary leptomeningeal melanocytomas, highlighting their rarity in supratentorial regions. The case underscores the importance of a multidisciplinary approach, incorporating clinical, radiological, and histopathological expertise for accurate diagnosis and tailored management. Ongoing research is crucial to refine treatment strategies, enhance prognostic precision, and improve outcomes for individuals with this uncommon CNS neoplasm.
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