医药学临床医学毕业论文 鼻腔原发性恶性黑色素瘤的临床病理观察

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1、湖南师范大学本科毕业论文考籍号：XXXXXXXXX姓名：XXX专业：医药学临床医学论文题目：鼻腔原发性恶性黑色素瘤的临床病理观察指导老师：XXX二〇一一年十二月十日湖南师范大学本科毕业论文考籍号：XXXXXXXXX姓名：XXX专业：医药学临床医学论文题目：鼻腔原发性恶性黑色素瘤的临床病理观察指导老师：XXX二〇一一年十二月十日［摘要］目的：探讨鼻腔原发性恶性黑色素瘤的临床、病理特点，以期掌握其诊断及相关鉴别诊断要领，提高其诊断准确率。方法：收集经特染及免疫组化确诊的鼻腔原发性恶性黑色瘤，并对其临床专科特征、生存随访情况、病理形态学特征及特染与免疫组化表型进行综合分析。结果：临床

2、症状为进行性鼻塞或(和)鼻衄，9例伴轻重不等的头痛。专科检查均见广基性息肉样新生物填塞鼻腔，表面有暗灰褐黑色样坏死物覆附，触之为血痂或坏死物、质脆。8例临床诊断为鼻息肉、鼻窦炎，5例诊断为鼻肿瘤、鼻出血坏死性息肉伴鼻窦炎。治疗为手术加放、化疗综合手段，生存时间为2个月～53个月。病理形态学12例均见胞质深红染的大多边形上皮样细胞及横纹肌样细胞为主，色素少。结论：鼻腔原发性恶性黑色素瘤是一种少见肿瘤，其生存期短、恶性度高。临床专科检查以息肉样外观伴表面灰褐色坏死为特点。病理学以胞质深红染仅有少量黑色素颗粒的大多边形上皮杆细胞及横纹肌样细胞为主要成分，黑色素特染及免疫组化可明确诊断

3、。　　［关键词］鼻腔；原发性恶性黑色素瘤；临床病理　　TheClinicopathologicalObservationon13CasesofPrimaryMalignantMelanomaoftheNasalCavity　　Abstract：ObjectiveToexploretheclinicopathologicalfeaturesoftheprimarynasalcavitymalignantmelanoma，soastomasterthediagnosticanddifferentialdiagnosticpointsandtoimprovethediagnostic

4、correctrate．MethodsThecasesofprimarymalignantmelanomaofnasalcavitywerecollectedwhichwerediagnosedbyhistochemicalandimmunohistochemicalstaining，andalltheotorhinolaryngologicalclinicalfeatures，livingstate，pathomorphismandthestainingtypeofimmunohistochemistryandhistochemistrywereaggregateanalys

5、ed．ResultsProgressivenasalobstructionor／andepistaxiswerethecommonclinicalsymptoms，and9caseshadlighttoheavyunequalheadache．Thenasalcavitywereobturatedbybroadstempolypoidneoplasmthroughotorhinolaryngologicalexamination，andsurfacewerecoveredwithspodofuscopiceousnecrosisont，whichwerehaemascabo

6、rnecrosisontandpregirrhexisbypalpate．8patientswereclinicaldiagnosticatedasrhinopolypus，nasosinusitisand5patientsasnasaloncosis?Rhinorrhagianecroticpolypsassociatedwithnasosinusitis?Thelivetimewere2monthsto53monthsthroughoperationandradiochemotherapy．Themajorpolygonepithelioidcellsandrhabdomy

7、oidcellswithcytoplasmcrimsonstainingwerethemaincomponentandhypopigmentin12casesfrompathomorphism．ConclusionItwasararetumorwithpoorlivespanandhighgradeoftheprimarynasalcavitymelanoma.Thepolypoidneoplasmassociatedwithsurfacespodofuscopiceousnecrosi