リンパ管造影実施後皮膚転移が促進された悪性黒色腫の1剖検例

MALIGNANT MELANOMA: A CASE OF SKIN METASTASIS WHICH WAS ACCELERATED BY LYMPHANGIOGRAPHY

はじめに

　悪性黒色腫は，症例により，その組織像にかなりの差がみられることはよく知られているところである。

　我々は，転移巣で組織学的に数種の所見を示し，リンパ管造影施行後，皮膚転移が促進された剖検例を経験したので報告する。

A 71-year-old woman had a black macule on the right ankle and had repeated erosion on the area since 10 years, which became an ulcer accompanied with right inguinal lymphnode swelling 6 years ago. She received a skin graft and extripation of the lymphnodes.

Two months before, she received extripation of the right inguinal lymphnodes and a test of lymphangiography.

Cutancus findings in our clinic were subcutaneous nodules, 10 and more in number, on the trunk. Swelling of the right lower extremity and the grafted area on the right ankle with several satellite black macules were also proved.

Histologic specimen from the primary lesion showed the typical picture of the malignant me-lanoma with anaplastic cells and junctional activity. That from the skin metastasis showed spindle-shaped, round, or dendritic tumor cells. Most of them were amelanotic and showed various degree of DOPA reaction.

That from the lymphnode showed melanized tumor cells in the lymphatic and blood vessels.

The metastasis was mainly found in the lymphatic tissues on the autopsy, and no metastasis could be proved in the central nervous system.

Our conclusion was that this was the case which the lymphangiography might accelerated the metastasis.