pee dark black
Introduction
Introduction Black urine, also known as dark brown urine, is more common in melanoma patients. Melanoma produces too much melanin. In the liver, small melanin is reduced to melanin. If a large amount of melanin is excreted from the urine and becomes melanin after oxidation, the urine of the melanoma patient becomes black urine as long as it is left for a while. Most of the lesions occur at the junction of the dermis and the epidermis. The tumor cells resemble sputum cells, but they are obviously heteromorphic. The interstitial cells and cells are filled with melanin. According to the cell morphology and the amount of melanin, the five types can be divided into five types.
Cause
Cause
(1) Causes of the disease
Melanoma can be composed of epidermal melanocytes, sputum cells or dermis into melanocytes. The tumor originates from the neural crest of the ectoderm. The melanocytes are arranged between the epidermis and the basal cells. After the cells produce pigment, the melanin particles are transported into the basal cells and hair through the dendrites. Most malignant melanomas occur because melanin is repeatedly muffled, grabbed and damaged, causing malignant transformation, inappropriate excavation and drug corrosion, which can convert benign melanin into malignant melanoma. Women during pregnancy or childbearing age can develop malignant melanoma rapidly, suggesting that the disease is associated with endocrine. In terms of age, it occurs mostly in middle-aged and elderly people, and very few occur before puberty. According to reports: 84% of malignant melanoma comes from benign sputum. According to Wieeio, many patients were not noticed at the beginning of the illness because of their small size. Some people think that benign sputum is the biggest source of malignant melanoma. Chinese medicine believes that: malignant melanoma occurs due to the wind and evil in the blood, change; or the blood of the veins, stagnation in the Wei, the yang qi bundle formed; the kidney in the turbid gas mixed with the yang, yang caused by the convergence, It is related to factors such as blood clotting and stagnation.
The true cause of normal melanocytoma is unclear and may be related to the following factors:
(1) Air pollution
The large amount of harmful substances such as Freon destroys the ozone layer, causing insufficient UV filtration. Harmful ultraviolet rays and harmful substances in the air work together on human skin, causing abnormal expression of melanocytes and causing melanoma.
(2) Love the heart of the heart
Many people use chemical cosmetics in order to purify the skin, causing chemical skin pollution. Some people even use chemical etchants to remove the black sputum on the skin. The result is counterproductive and stimulates the excessive proliferation of melanocytes.
(3) Lack of health knowledge
Black scorpion, which is prone to friction in the foot and perineum, has not received enough attention. Due to its long-term compression and friction, it eventually causes a malignant transformation.
(4) Abuse of estrogens: The study found that there are estrogen receptors in the cells of malignant melanoma. Therefore, it is suspected that excessive estrogen will stimulate melanoma.
(5) Impaired defects: With the improvement of living standards, the life expectancy of Chinese people has been significantly extended. With the increase of age, the body's immune function is gradually declining. The study found that low immune function is one of the important causes of melanoma, so the incidence of melanoma in the elderly is very high.
(6). Benign melanin plaque: that is, black sputum, in which the junction is most likely to be malignant, mixed sputum is less, and endothelium is rarely malignant. However, most of the scalp melanoma is not changed from black sputum, so some people think that this disease is not completely related to black sputum.
(7) Ethnic whites have a higher incidence than colored people. For example, the annual incidence rate of Caucasians in the United States is as high as 42/100,000, while that of blacks is only 0.8/100,000.
(two) pathogenesis
Most of the lesions occur at the junction of the dermis and the epidermis. The tumor cells resemble sputum cells, but they are obviously heteromorphic. The interstitial cells and cells are filled with melanin. According to the different cell morphology and melanin content, it can be divided into 5 types:
1. Large epithelioid cells are more common, and the cells are polygonal.
2. Small epithelioid-like nuclei are large and not typical.
3. The cytoplasm of spindle cells is fibrilla-like, with large nuclear staining.
4. The deformed cells are mononuclear or multinuclear.
5. Dendritic cells are larger than normal melanocytes, and the nucleus is abnormal. The tumor cells are strongly positive for casein. When the melanin is small, it is difficult to confirm in HE slices, so it is called "no melanin melanoma", but if With silver staining, melanin can still be detected in a small number of cells.
Examine
an examination
Related inspection
Urinary urinary infection, urine, routine nephropathy, urine routine
1. Anti-human melanoma serum is indirectly immunofluorescent labeled melanin tissue, when the antiserum is diluted to 1:2, the highest positive rate can reach 89%.
2. Using the Vacca double PAP immunoenzyme labeling assay, when the antiserum dilution was 1:400, 82.14% was positive.
3. Pigmentation examination The melanin is oxidized after being excreted by the kidney, so that the urine is dark brown, called black urine. If ferric chloride, potassium dichromate or sulfuric acid is added to the urine, it can promote its oxidation, and then add sodium nitrate, the urine is purple; first add acetic acid, then add sodium hydroxide, the urine is blue.
Diagnosis
Differential diagnosis
Pediatric urine blue: is a complication of pediatric blue diaper syndrome. The disease generally shows symptoms such as anorexia, vomiting, constipation, irritability, weight loss, and visual loss. The child was pale, pygmy, flattened in the nose, with internal epithelium, nystagmus, squinting, optic disc edema, and optic atrophy.
Urine red sauce or soy sauce color: diagnosis of malaria nephropathy, urine test can be seen in urine red sauce or soy sauce color, some patients with long-term unhealed, can appear nephrotic syndrome.
Green urine: Green urine is discharged when a large number of anti-inflammatory drugs or Pseudomonas aeruginosa are born in the urine. It is seen when there is a growth of Pseudomonas aeruginosa in the urine, or when the bilirubin urine is left for too long and is oxidized into biliverdin.
Purulent urine: caused by severe urinary purulent infection, urine is milky white. Purulent urine is common in pyelonephritis, cystitis, renal abscess, urethritis, or severe renal tuberculosis. Chyluria is one of the main symptoms of filariasis, white urine like milk. Because the intestinal absorption of the chyle (the liquid after the saponification of fat) can not be drained from the normal lymphatics to the blood circulation, it can only flow back into the lymphatics of the urinary system, causing the lymphatic pressure in the urinary system to increase, varicose and rupture. The chyle is spilled into the urine, and chyluria appears. Chyluria is generally paroxysmal. When there are red blood cells in the chyluria, it is called chyluria. Microfilaments (ie, young silkworms) can sometimes be found in the blood and urine of patients with chyluria.
