{"id":11223,"date":"2026-08-16T20:00:00","date_gmt":"2026-08-16T18:00:00","guid":{"rendered":"https:\/\/konspat.pl\/?p=11223"},"modified":"2026-08-24T21:18:39","modified_gmt":"2026-08-24T19:18:39","slug":"przypadek-377","status":"publish","type":"post","link":"https:\/\/konspat.pl\/index.php\/2026\/08\/16\/przypadek-377\/","title":{"rendered":"Przypadek 377."},"content":{"rendered":"\n<p class=\"wp-block-paragraph\">Pacjentka 78 lenia z szybko powi\u0119kszaj\u0105cym si\u0119 br\u0105zowym, niebolesnym guzkiem sk\u00f3ry lewego podudzia. Zmian\u0119 usuni\u0119to.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Do badania makroskopowego nades\u0142ano wrzeciono sk\u00f3ry wym. 2&#215;1,5&#215;1,2cm. W cz\u0119\u015bci centralnej obecny jest kopulasty, br\u0105zowy, owrzodzia\u0142y guzek wymiar\u00f3w 1,2x1x0,8cm. Najmniejszy boczny margines operacyjny wynosi oko\u0142o 0,3cm.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Obrazy mikroskopowe:<\/p>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"777\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205338-1024x777.jpg\" alt=\"\" class=\"wp-image-11213\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205338-1024x777.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205338-300x228.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205338-768x582.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205338-1536x1165.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205338-2048x1553.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205355-1024x768.jpg\" alt=\"\" class=\"wp-image-11214\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205355-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205355-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205355-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205355-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205355-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"870\" height=\"1024\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205418-870x1024.jpg\" alt=\"\" class=\"wp-image-11215\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205418-870x1024.jpg 870w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205418-255x300.jpg 255w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205418-768x904.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205418-1305x1536.jpg 1305w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205418-1740x2048.jpg 1740w\" sizes=\"auto, (max-width: 870px) 100vw, 870px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205433-1024x768.jpg\" alt=\"\" class=\"wp-image-11216\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205433-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205433-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205433-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205433-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205433-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205916-1024x768.jpg\" alt=\"\" class=\"wp-image-11222\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205916-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205916-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205916-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205916-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205916-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"871\" height=\"1024\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205607-871x1024.jpg\" alt=\"\" class=\"wp-image-11219\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205607-871x1024.jpg 871w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205607-255x300.jpg 255w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205607-768x903.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205607-1307x1536.jpg 1307w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205607-1742x2048.jpg 1742w\" sizes=\"auto, (max-width: 871px) 100vw, 871px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205459-1024x768.jpg\" alt=\"\" class=\"wp-image-11217\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205459-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205459-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205459-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205459-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205459-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205546-1024x768.jpg\" alt=\"\" class=\"wp-image-11218\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205546-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205546-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205546-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205546-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205546-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205656-1024x768.jpg\" alt=\"\" class=\"wp-image-11220\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205656-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205656-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205656-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205656-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205656-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205806-1024x768.jpg\" alt=\"\" class=\"wp-image-11221\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205806-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205806-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205806-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205806-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/IMG_20201103_205806-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Cechy charakterystyczne:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li>w obr\u0119bie sk\u00f3ry w\u0142a\u015bciwej obecne s\u0105 gniazda \/krzy\u017cyk\/ atypowych melanocyt\u00f3w (o morfologii nab\u0142onkowatej \/obfita kwasoch\u0142onna cytoplazma, j\u0105dro kom\u00f3rkowe powi\u0119kszone, widoczne j\u0105derka, czerwona strza\u0142ka\/ lub wrzecionowatej \/ wyd\u0142u\u017cone kom\u00f3rki o kwasoch\u0142onnej cytoplazmie, j\u0105dra kom\u00f3rkowe powi\u0119kszone, z zaznaczonymi j\u0105derkami\/, cz\u0119\u015b\u0107 z nich z widocznymi ziarnami br\u0105zowej melaniny \/br\u0105zowa strza\u0142ka\/)<\/li>\n\n\n\n<li>brak komponenty radialnej wzrostu (wi\u0119cej ni\u017c 3 s\u0105siaduj\u0105ce ze sob\u0105 brodawki sk\u00f3ry po obu stronach guza), jedynie komponenta wertykalna<\/li>\n\n\n\n<li>je\u017celi zaj\u0119ty jest nask\u00f3rek (pojedyncze kom\u00f3rki lub gniazda) to wy\u0142\u0105cznie w obszarze bezpo\u015brednio nad zmian\u0105, s\u0105siaduj\u0105ca sk\u00f3ra nie wykazuje cech regresji (w\u0142\u00f3knienie, szkliwienie, odczyn zapalny, melanofagi lub wolno le\u017c\u0105ce ziarna melaniny)<\/li>\n\n\n\n<li>guzek cz\u0119sto otoczony jest tzw ko\u0142nierzykiem nask\u00f3rkowym<\/li>\n\n\n\n<li>mog\u0105 wyst\u0119powa\u0107 nad\u017cerki lub owrzodzenia \/gwiazdka\/, obecno\u015b\u0107 inwazji naczyniowo- limfatycznej i oko\u0142onerwowej, ogniskowa martwica, liczne w tym atypowe figury podzia\u0142u<\/li>\n\n\n\n<li>brak historii czerniaka lub przerzut\u00f3w czerniaka<\/li>\n\n\n\n<li>IHC: S100(+), SOX10, HMB45(+), PRAME(+), PanCK(-).<\/li>\n<\/ul>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"871\" height=\"1024\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/czerniak-guzkowy-2--871x1024.jpg\" alt=\"\" class=\"wp-image-11205\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/czerniak-guzkowy-2--871x1024.jpg 871w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/czerniak-guzkowy-2--255x300.jpg 255w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/czerniak-guzkowy-2--768x903.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/czerniak-guzkowy-2--1307x1536.jpg 1307w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/czerniak-guzkowy-2--1742x2048.jpg 1742w\" sizes=\"auto, (max-width: 871px) 100vw, 871px\" \/><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/S100-1024x768.jpg\" alt=\"\" class=\"wp-image-11211\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/S100-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/S100-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/S100-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/S100-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/S100-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">S100<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/MelanA-1024x768.jpg\" alt=\"\" class=\"wp-image-11209\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/MelanA-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/MelanA-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/MelanA-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/MelanA-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/MelanA-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">MelanA<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/SOX10-1024x768.jpg\" alt=\"\" class=\"wp-image-11212\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/SOX10-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/SOX10-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/SOX10-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/SOX10-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/SOX10-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">SOX10<\/figcaption><\/figure>\n\n\n\n<figure class=\"wp-block-image size-large\"><img loading=\"lazy\" decoding=\"async\" width=\"1024\" height=\"768\" src=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/PRAME-1024x768.jpg\" alt=\"\" class=\"wp-image-11210\" srcset=\"https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/PRAME-1024x768.jpg 1024w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/PRAME-300x225.jpg 300w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/PRAME-768x576.jpg 768w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/PRAME-1536x1152.jpg 1536w, https:\/\/konspat.pl\/wp-content\/uploads\/2026\/08\/PRAME-2048x1536.jpg 2048w\" sizes=\"auto, (max-width: 1024px) 100vw, 1024px\" \/><figcaption class=\"wp-element-caption\">PRAME<\/figcaption><\/figure>\n\n\n\n<p class=\"wp-block-paragraph\">Rozpoznanie:<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Czerniak sk\u00f3ry, typ guzkowy (Nodular melanoma) &#8211; w oparciu o dane kliniczne.<\/p>\n\n\n\n<p class=\"wp-block-paragraph\">Dodatkowe zdj\u0119cia i informacje:<\/p>\n\n\n\n<ul class=\"wp-block-list\">\n<li><a href=\"https:\/\/patologia.cm.umk.pl\/atlas\/skin\/melanocytic\/nodular2\/index2.html\">https:\/\/patologia.cm.umk.pl\/atlas\/skin\/melanocytic\/nodular2\/index2.html<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.pathologyoutlines.com\/topic\/skintumormelanocyticnodularmelanoma.html\">https:\/\/www.pathologyoutlines.com\/topic\/skintumormelanocyticnodularmelanoma.html<\/a><\/li>\n\n\n\n<li><a href=\"https:\/\/www.webpathology.com\/images\/dermpath\/proliferations-and-neoplasms\/melanoma---clinico-pathologic-subtypes#1398\">https:\/\/www.webpathology.com\/images\/dermpath\/proliferations-and-neoplasms\/melanoma&#8212;clinico-pathologic-subtypes#1398<\/a><\/li>\n<\/ul>\n","protected":false},"excerpt":{"rendered":"<p>Pacjentka 78 lenia z szybko powi\u0119kszaj\u0105cym si\u0119 br\u0105zowym, niebolesnym guzkiem sk\u00f3ry lewego podudzia. Zmian\u0119 usuni\u0119to. Do badania makroskopowego nades\u0142ano wrzeciono<\/p>\n","protected":false},"author":46,"featured_media":11219,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":"","_links_to":"","_links_to_target":""},"categories":[16,23],"tags":[],"class_list":["post-11223","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-akademia-patologa","category-przypadki"],"post_mailing_queue_ids":[],"_links":{"self":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts\/11223","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/users\/46"}],"replies":[{"embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/comments?post=11223"}],"version-history":[{"count":2,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts\/11223\/revisions"}],"predecessor-version":[{"id":11259,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/posts\/11223\/revisions\/11259"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/media\/11219"}],"wp:attachment":[{"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/media?parent=11223"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/categories?post=11223"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/konspat.pl\/index.php\/wp-json\/wp\/v2\/tags?post=11223"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}