Analiza vaskularnih obrazaca 52 amelanotične kutane metastaze melanoma: prospektivno deskripitvna studija
Sažetak
Uvod/Cilj. Rana dijagnoza amelanotičnih kutanih metastaza melanoma (AKMM) predstavlja veliki izazov i od izuzetnog je značaja za određivanje stadijuma, lečenje i prognozu bolesti. Cilj rada bio je da se procene vaskularne strukture i njihov raspored i učestalost u AKMM. Metode. Studija je sprovedena kao prospektivna, deskriptivna, multicentrična studija patohistološki potvrđenih AKMM. Rezultati. Istraživanje je uključilo ukupno 52 AKMM kod 17 bolesnika (8 muškaraca i 9 žena, starosti 32–91 godina, prosečno 63,12 godina) sa prethodnom istorijom primarnog melanoma. Najzastupljenije su bile uzdignute AKMM – 39 (75,0%) lezija, dok je 13 (25,0%) AKMM bilo u nivou kože, ravnih. Linearni iregularni krvni sudovi bili su statistički značajno češće povezani sa uzdignutim AKMM u odnosu na ravne AKMM (92,3% vs. 50,0%, p < 0,001). Tačkasti krvni sudovi bili su statistički značajno češći kod ravnih AKMM u odnosu na uzdignute AKMM (76,9% vs. 28,2%, p = 0,003). Difuzna distribucija krvnih sudova bila je najzastupljenija, u 92,3% ravnih AKMM i 76,9% uzdignutih AKMM (p = 0,416). Periferni raspored krvnih sudova utvrđen je u 15,4% uzdignutih AKMM i u 7,7% ravnih AKMM (p = 0,815). Centralni raspored krvnih sudova uočen je u 2,6%, a klaster (segmentni) raspored u 5,1% uzdignutih AKMM. Monomorfni vaskularni obrazac bio je prisutan kod 84,6% ravnih AKMM i 61,5% uzdignutih AKMM (p = 0,232). Zaključak. Naša studija podržava nalaz da su linearni iregularni krvni sudovi češće povezani sa uzdignutim AKMM, dok su tačkasti krvni sudovi dominantni kod AKMM u nivou kože.
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