资源描述：
《黑色素瘤课件_5》由会员上传分享，免费在线阅读，更多相关内容在教育资源-天天文库。
1、MelanomaEdwardBuckingham,M.D.CombinedPlasticsConferenceSeptember6,2000Melanoma-OutlineGeneralstatisticsanddevelopmentRiskfactorsandpatientassessementPathologyandprognosisWork-upandstagingSurgicaltreatmentLymphnodecontroversy/sentinelnodeAdjuvanttherapyMelanoma-DataIncidenceincreasefas
2、testMortalityincrease2ndonlytolung5thmostprevalent,incidence7%/yearincrease5%skincancer,75%skincancerdeath1/75in2000,1/1500in193520%H&N,51%facial,26%scalp,16%neck,9%earDevelopmentofNeviMelanocytesdendritic,neuralcrest,basalcelllayersynthesisofmelanin1/10tokeratinocyteshyperplasia-tann
3、ing/lentigines,increasedratioNevustransformationpoorlyunderstooddendritic-roundednolongerlentigionouspattern-nestsDevelopmentofNeviJunctionalnevinestsalongdermal-epidermaljunctionCompoundnevi“invade”dermis,firstasneststhencordsandsinglecellsDermalnevijunctionalcomponentlostEvolutionof
4、NeviMelanocyteHyperplasiaJunctionalNeviCompoundNeviDermalNeviDevelopementofMelanomaQuestionablebenignmelanocytesprogressivehyperplasia/dysplasiaRadialgrowthinepidermis,linesofradii,noexpansivenestsornodulesslowunrestricted,nometastaticpotentialDevelopmentofMelanomaVerticalgrowthvertic
5、allyintodermisexpansiveandcoalescentnestsandnodulesmetastaticpotentialdermallymphaticandvascularinvasionGrowthpatternsbiphasic-slowradialmonthstoyears-rapidverticalgrowthmonophasic-rapidverticalgrowthonlyEvolutionofMelanomaDysplasticNevibordermelanocyticneviandmalignantmelanomaclinica
6、lresemblesmalignantmelanomalentiginouscompoundnevus,prominentbridgingacrossreteridgesaberrantininter-retespaceslamellarfibrosisofpapillarydermis,variablelymphoidresponseDysplasticNeviDysplasticNeviTypesofMelanomaAcrallentiginousMucosalmelanomaSuperficalspreadingmelanomaLentigomalignam
7、elanomaNodularmelanomaSuperficialspreadingmostcommonheadandneck,50%4thto5thdecadeclinicalmixtureofbrown/tan,pink/whiteirregularborders,biphasicgrowthirregularnestsinepidermisunderlyinglymphoidinfiltrateenlargednestsandsinglecellsinallepidermallayersSuperficialspreadingLentigomaligna20
8、%ofhe
