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頁籤選單縮合
題名 | Contradiction of Clinical Expectations in Lymphoscintigraphy Sentinel Node Mapping in Detecting Microscopic Melanoma Metastasis=淋巴閃爍攝影偵測與臨床上預期不同的前哨淋巴結顯微黑色素細胞瘤轉移 |
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作者 | 張文震; 江雪芳; 羅永豐; 陳建勳; 高潘福; | 書刊名 | 長庚醫學 |
卷期 | 25:7 2002.07[民91.07] |
頁次 | 頁474-479 |
分類號 | 415.138 |
關鍵詞 | 前哨淋巴結; 黑色素細胞瘤; 顯微轉移; Sentinel lymph node; Malignant melanoma; Microscopic metastasis; |
語文 | 英文(English) |
中文摘要 | 一位51歲男性於背部皮膚第4椎身體中線處長一個10×10mm的結節型黑色素細胞瘤,深度5mm侵犯至皮膚下層;理學檢查時發右側腹股溝有一個20×20mm的淋巴結,骨盆腔電腦斷層檢查並未發現左側腹股溝、兩側腸骨或主動脈旁有淋巴結腫大。淋巴閃爍攝影發現有一個前哨淋巴結在左側腹股溝部位,組織學檢查發現此4mm前哨站淋巴結有一小群腫瘤細胞,並經由HMB-45免疫組染色實為黑色素細胞瘤。而原先右側觸診發現的淋巴結卻沒有被腫瘤腦胞侵犯。這位病患隨後托受左側腹股溝淋巴結廓清術,所清除的其餘14顆小淋巴結中未再發現倀何腫瘤細胞轉移現象。經過9個月的追蹤此病人目前尚無復發跡象。 |
英文摘要 | A 51-year-old man presented with lower back skin pigmentation tag that he had had for 2 years. Physical examination showed a 10×10 mm ulcerated, protruding pigmented skin mass at the midline of back at the 4th lumbar spine level. Skin biopsy disclosed a 5 mm thickness nodular melanoma, which had invaded the reticular dermis. In additions, a 20×20 mm lymph node in the right inguinal region was noted. A pelvic computed tomography scan revealed no definite evidence of lymph node enlargement in the left inguinal, bilateral iliac or para-aortic region. However, the 99mTc-sulfurcolloid dynamic lymphoscintigraphy revealed a sentinel lymph node (SLN) in the left inguinal area. The histological examination of the 4-mm SLN demonstrated a small cluster of metastatic melanoma, which was confirmed using HMB-45 immunohisytochemical stain. Meanwhile, no melanoma cells were seen in the right enlarged inguinal lymph node. Subsequently, complete left inguinal lymph node dissection was performed, which confirmed that there was no melanoma metastasis in any of remaining 14 nodes. The patient underwent regular follow-up for 9 months and had no evidence of malignancy recurrence to data. |
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