Spitz样黑色素病变的鉴别及研究进展

Differentiation and Research Progress of Spitz-Like Melanin Lesions

摘要: 在临床工作中，Spitz样黑色素细胞病变大致可分为良性的Spitz痣、非典型Spitz痣以及恶性Spitz痣样黑色素瘤，它们在临床表现及形态学上往往相似，难以区分，鉴别较为困难，容易误诊。多年来围绕它们的诊断等一直困扰着临床工作者。目前Spitz痣被认为是良性的，然而，Spitz痣出现转移并导致死亡的病例也是有报道的。非典型Spitz痣很少见，但非典型Spitz痣的临床、皮肤镜和组织病理学特征与恶性Spitz样黑色素瘤及Spitz痣重叠，因此非典型病变在诊断和治疗方面最具争议性，因为其恶性潜能尚不清楚。黑色素瘤恶性程度高，早期发现并治疗是预后良好的关键。本文将对该系疾病进行总结，以提高对其认识。

Abstract: In clinical work, Spitz-like melanocytic lesions can be divided into benign Spitz nevus, atypical Spitz nevus and malignant Spitz nevoid melanoma. They are often similar in clinical manifestation and morphology, difficult to distinguish and easy to be misdiagnosed. The diagnosis around them has been perplexing clinical workers for many years. At present, Spitz nevus is considered to be benign. However, cases of metastasis and death of Spitz nevus have also been reported. Atypical Spitz nevus is rare, but the clinical, dermatoscopic and histopathological features of atypical Spitz nevus overlap with malignant Spitz-like melanoma and Spitz nevus. Therefore, atypical lesions are the most con-troversial in diagnosis and treatment, because their malignant potential is not clear. Melanoma has a high degree of malignancy, early detection and treatment is the key to a good prognosis. This arti-cle will summarize the diseases of this department in order to improve their understanding.