--本文经《美国外科病理学杂志》授权发布，其他媒体转载或引用须经《美国外科病理学杂志》同意，否则追究法律责任。
肢端Spitz痣罕见且文献报道极少。表皮交界处的非典型结构及Spitz样的细胞学特点导致其易被误诊为恶性黑色素瘤。为研究其临床病理及免疫组织化学染色特征，从科室存档资料中选取50例位于肢端的Spitz痣病例，获取其临床资料和随访信息，并分析其组织学特征。对50例肢端 Spitz痣进行P16及P21免疫组织化学染色，并与10例肢端雀斑样恶性黑色素瘤及10例肢端痣进行对比。肢端Spitz痣常发生在年轻（中位数：24.5岁；范围：4~61岁）女性患者，足部多发。色素性病变大小1~15mm（中位数：4mm）。45例患者的有效随访资料（中位数：48个月；范围：4~228个月）显示无局部复发、转移及死亡。组织学上，肢端Spitz痣由大的上皮样和/或梭形痣细胞组成，界限清晰，有时分布稍不对称，在交界处形成雀斑样和巢状生长方式及形成“肩部”。常见明显的派杰样生长和贯穿表皮的痣细胞巢。可见局部痣细胞成熟性改变，无细胞核异型及核分裂象。与肢端痣及肢端雀斑样恶性黑色素瘤不同，肢端Spitz痣弥漫强阳性表达P16和P21。肢端Spitz痣是具有良性生物学行为的Spitz痣的特殊类型。关注其细微的组织学鉴别点及P16/P21蛋白表达模式有助于将其与恶性黑色素瘤相区分。
Am J Surg Pathol 2018;42:821-827
美国外科病理学杂志中文版2019年第一期摘要NO.6
孔令非翻译/审校
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