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1
2 Fontana-Masson (bleeching) DOPA S-100, HMB-45, Melan A, tyrosinase)
3 m:k=1:4 1:10 DOPA Fontana-Masson
4
5
6
7 de novo (75 %) (25%)
8 melanoma in situ invasive melanoma
9
10 Symmetry: Well circumscription: Regularity in size, shape and distribution:
11 ABCDE rule Asymmetry Border irregularity Color variegation Diameter generally greater than 6 mm 6mm Elevation Melanocytic nevus Melanoma
12 ABCD rule
13 Lentigo Melanocytic nevus (nevus incipiens, jentigo) Melanocytic nevus (junctional nevus)
14 Normal epidermis Lentigo Junctional nevus Early compound nevus Later compound nevus Intradermal nevus Senescence of nevus
15 small (<1.5cm) medium-sized (1.5 10cm) large (>10cm) (e.g. nodal nevus) junctional compound intradermal congenital acquired regular dysplastic nevomelanocytic balloon cell epithelioid cell spindle cell etc. desmoplastic halo (lymphocytic infiltration) deep penetrating combined nevus junction + blue; compound + blue; Spitz + nevomelanocytic; Spitz + blue
16 congenital nevus, combined (eruptive; agminated) nevus, nevus incipiens, nevi of volar skin, mucosal nevus, recurrent nevus, Spitz s nevus
17 Acquired nevus (6mm ) nest, theque cohesive) Spitz s nevus Junctional compound - intradermal
18 10 mm 5 mm 2 mm 1 mm
19 Junctional nevus 6 mm nest theque
20 Compound and intradermal nevus 6 mm nest theque
21 Congenital nevus 6 mm nest theque
22 Combined or eruptive nevus 6 mm nest theque
23 Recurrent nevus 6 mm nest theque
24 Nevus of volar skin 6 mm nest theque
25 Spitz s nevus, junctional 6 mm nest theque
26 melanoma in situ invasive melanoma
27 6 mm asymmetry poor circumscription (solitary melanocyte) (nest, theque) (ascent) nest nest nest 10 nest
28 6 mm asymmetry poor circumscription (solitary melanocyte) (nest, theque) (ascent) nest nest nest 10 nest
29 6 mm asymmetry poor circumscription (solitary melanocyte) (nest, theque) (ascent) nest nest nest 10 nest
30 6 mm asymmetry poor circumscription (solitary melanocyte) (nest, theque) (ascent) nest nest nest 10 nest
31 6 mm asymmetry poor circumscription (solitary melanocyte) (nest, theque) (ascent) nest nest nest 10 nest
32 6 mm asymmetry poor circumscription (solitary melanocyte) (nest, theque) (ascent) nest nest nest 10 nest
33 ABCD rule Asymmetry Border irregularity Color variegation nest Diameter generally greater than 6 mm 6mm 6mm Melanoma
34
35 heterochromasia (retraction)
36
37
38
39 6 mm maturation
40 6 mm maturation
41 6 mm maturation
42 6 mm maturation
43 6 mm maturation
44
45 prominent nucleoli hyperchromasia
46 prominent nucleoli hyperchromasia
47 prominent nucleoli hyperchromasia
48
49
50 amelanotic melanoma
51 amelanotic melanoma
52 amelanotic melanoma
53 Clark Clark I: II: III: IV: V: II III Breslow mm 1 mm Breslow TNM (AJCC, 2000)
54 Masson
55 5mm Satelite metastasis
56
57
58 Clues to suggest melanoma
59 Melanocytic lesion solar elastosis Lentigo maligna (melanoma in situ)
60 junctional compound melanocytic nevus melanoma Nevus Malignant melanoma
61 Am. J. Dermatopathol 2006; 28:21-27 Crista profunda intermedia acral melanoma
62 elongated dendrite
63 Caveats
64 Nevomelanocyte congenital nevus
65 5mm
66 Masson
67 Clark Clark I: II: III: IV: V: II III Breslow mm 1 mm Breslow TNM (AJCC, 2000)
68
69
70
71
72
73
74 Melanoma in situ
75
76
77
78 Melanoma in situ (at least on this section)
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Glioma 28% astrocytoma (WHO I) 0.28 anaplastic (WHO II/III) 0.18 Glioblastoma (WHO IV) 0.32 others 0.22 Meningioma partly malignant) 26% Pituitary adenoma 17% Neurinoma 11% Craniopharyngioma etc 5% Others
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悪性黒色腫・メラノーマなら新しい皮膚科学｜皮膚病全般に関する最新情報を載せた皮膚科必携テキスト
悪性黒色腫 457 Hodgkin 病, 非 Hodgkin リンパ腫悪性リンパ腫は Hodgkin 病と非 Hodgkin リンパ腫に分類され, 日本では 90% が非 Hodgkin リンパ腫である. Hodgkin 病は無痛性のリンパ節腫脹から初発し, 次第に進展する. 特異的な皮疹がみられることはまれであるが, 転移によって続発性に丘疹や結節が生じることがある. また, Hodgkin 痒疹と呼ばれる皮疹や,
平成18年版 男女共同参画白書
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1 2420128 1 1 6 3 2 198808 189/1 1988081891 3 4 5 JISJIS X 0208 http://www.pref.hiroshima.lg.jp/site/monjokan/ 1... 1... 1... 1... 1... 2... 3... 3... 8... 8... 8... 9 2... 9... 9... 10... 11... 13...
23 15961615 1659 1657 14 1701 1711 1715 11 15 22 15 35 18 22 35 23 17 17 106 1.25 21 27 12 17 420,845 23 32 58.7 32 17 11.4 71.3 17.3 32 13.3 66.4 20.3 17 10,657 k 23 20 12 17 23 17 490,708 420,845 23
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 ( ) 24 25 26 27 28 29 30 ( ) ( ) ( ) 31 32 ( ) ( ) 33 34 35 36 37 38 39 40 41 42 43 44 ) i ii i ii 45 46 47 2 48 49 50 51 52 53 54 55 56 57 58
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i ii (1) (1) (2) (1) (3) (1) (1) (2) (1) (3) (1) (1) (2) (1) (3) (2) (3) (1) (2) (3) (1) (1) (1) (1) (2) (1) (3) (1) (2) (1) (3) (1) (1) (1) (2) (1) (3) (1) (1) (2) (1) (3)
