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Gaurav V, Anand GRP, Khandpur S. Intradermal naevus with fat: A distinct variant. Indian J Dermatol Venereol Leprol 2024; 0:1-4. [PMID: 38899416 DOI: 10.25259/ijdvl_973_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 04/09/2024] [Indexed: 06/21/2024]
Affiliation(s)
- Vishal Gaurav
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Rozza-de-Menezes RE, Brum CDAI, Gaglionone NC, de Sousa Almeida LM, Andrade-Losso RM, Paiva BVB, Faveret PLS, da Silva AV, Siqueira OHK, Riccardi VM, Cunha KS. Prevalence and clinicopathological characteristics of lipomatous neurofibromas in neurofibromatosis 1: An investigation of 229 cutaneous neurofibromas and a systematic review of the literature. J Cutan Pathol 2018; 45:743-753. [PMID: 29959804 DOI: 10.1111/cup.13315] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2018] [Revised: 06/10/2018] [Accepted: 06/25/2018] [Indexed: 12/26/2022]
Abstract
BACKGROUND Lipomatous neurofibroma (Lnf) is a histopathological variant with adipocytes noted among cells of cutaneous neurofibromas. We aimed to investigate the prevalence and clinicopathological features of Lnfs of neurofibromatosis 1 (NF1)-associated cutaneous neurofibromas and to review the literature systematically. We also evaluated the expression of leptin (a hormone involved in lipid metabolism) in neurofibromas to better understand the pathogenesis of Lnfs. METHODS A prospective histologic study was conducted on 229 cutaneous neurofibromas from 85 NF1 individuals. Leptin expression was immunohistochemically evaluated in 111 cutaneous neurofibromas. To systematically review the literature, two authors independently performed literature searches without year restriction. RESULTS Forty (17.5%) neurofibromas were lipomatous. Lnfs were significantly larger lesions and associated with females. Eighteen (7.9%) of all neurofibromas had multinucleated floret-like giant cells, and these were associated with Lnfs. All neurofibromas expressed leptin. We systematically reviewed 13 articles. Three large studies investigated Lnfs mainly in sporadic neurofibromas and suggested that 0.3% to 8.0% of tumors (NF1 and sporadic) are Lnfs. CONCLUSION In NF1, Lnfs are common, mainly in larger tumors and women. All cutaneous NF1-neurofibromas express leptin. It is unknown if the expression of leptin accounts for the lipomatous variant, but it may have a role in the pathogenesis of cutaneous neurofibroma.
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Affiliation(s)
- Rafaela Elvira Rozza-de-Menezes
- Department of Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose, CNNF), Rio de Janeiro, Brazil
| | | | | | - Lilian Machado de Sousa Almeida
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose, CNNF), Rio de Janeiro, Brazil
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
| | - Raquel Machado Andrade-Losso
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose, CNNF), Rio de Janeiro, Brazil
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | - André Vallejo da Silva
- Breast Surgery Service, Antônio Pedro University Hospital, Universidade Federal Fluminense, Niterói, Brazil
| | | | | | - Karin Soares Cunha
- Department of Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
- Neurofibromatosis National Center (Centro Nacional de Neurofibromatose, CNNF), Rio de Janeiro, Brazil
- Graduate Program in Pathology, School of Medicine, Universidade Federal Fluminense, Niterói, Brazil
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Fernandez-Flores A, Cassarino DS. Unusual Histopathological Patterns in Melanocytic Nevi With Some Previously Undescribed Patterns. Am J Dermatopathol 2016; 38:167-85. [PMID: 26894768 DOI: 10.1097/dad.0000000000000381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Melanocytic nevi are one of the most common diagnoses in the daily practice of any dermatopathologist. Although in the vast majority of cases the final diagnosis is not difficult, there are certain rare and unusual morphologic variations that can elicit some diagnostic problems. Although some of these variations can be considered as mere morphologic oddities, others might lead to a differential diagnosis with melanoma, or with other tumors, including epithelial or neural tumors. In the current report, we review many of these morphologic variations and discuss the main differential diagnosis, when appropriate.
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Affiliation(s)
- Angel Fernandez-Flores
- *Consultant Histopathologist, Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain; and †Consultant Dermatopathologist, Department of Pathology, Southern California Kaiser Permanente, Los Angeles Medical Center (LAMC), Los Angeles, CA
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Yavuzyigitoglu S, Kilic E, Vaarwater J, de Klein A, Paridaens D, Verdijk RM. Lipomatous Change in Uveal Melanoma: Histopathological, Immunohistochemical and Cytogenetic Analysis. Ocul Oncol Pathol 2015; 2:133-5. [PMID: 27239451 DOI: 10.1159/000440981] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 09/08/2015] [Indexed: 11/19/2022] Open
Abstract
PURPOSE The aim of this study was to describe a case of lipomatous change in uveal melanoma. PROCEDURES The patient presented with a 2-year history of blurry vision. A full examination of the right eye revealed a dome-shaped pigmented subretinal mass in the choroid with a thickness of 9 mm and a diameter of 15 mm. The eye was enucleated and prepared for histopathologic, genetic and molecular investigation. RESULTS Histopathology revealed a small circumscribed area consisting of mature adipocytic appearing cells with abundant clear cytoplasm and small peripheral flattened nuclei within a spindle-cell melanoma of the uvea. The cytoplasm of the adipocytic cells stained negative for periodic acid-Schiff and Alcian blue and positive for Melan-A, HMB-45 and tyrosinase, confirming melanocytic lineage. Fluorescence in situ hybridization analysis confirmed trisomy of chromosome 6p22 and disomy of chromosome 3p13 in the nuclei of both the tumor spindle type B cells and in the nuclei of lipomatous tumor cells. CONCLUSIONS Lipomatous change can be added to the many histopathologic faces of uveal melanoma. To our knowledge, this is the first report of lipomatous change in uveal melanoma performed with cytogenetic investigations.
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Affiliation(s)
- Serdar Yavuzyigitoglu
- Department of Ophthalmology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Clinical Genetics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Emine Kilic
- Department of Ophthalmology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Jolanda Vaarwater
- Department of Clinical Genetics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Annelies de Klein
- Department of Clinical Genetics, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | | | - Robert M Verdijk
- Section of Ophthalmic Pathology, Department of Pathology, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Ball NJ, Kho GT. Melanocytic nevi are associated with neurofibromas in neurofibromatosis, type I, but not sporadic neurofibromas: a study of 226 cases. J Cutan Pathol 2005; 32:523-32. [PMID: 16115049 DOI: 10.1111/j.0303-6987.2005.00376.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurofibromatosis, type 1, is associated with cutaneous melanin pigmentation, but an association with ordinary melanocytic nevi has not been described. METHODS This retrospective case-control study was designed to see if neurofibromas in patients with neurofibromatosis, type 1 (NF-1) differ from sporadic neurofibromas (SN) in their incidence of associated melanocytic nevi and other histologic features. Slides from 114 NF-1 were compared with 112 SN and 300 intradermal melanocytic nevi (IDN). RESULTS Small lentiginous melanocytic nevi were identified over 13 NF-1 (11%) but no SN (P=0.0002). Compared with other NF-1, NF-1 with nevi were more frequently associated with melanocytic hyperplasia, giant melanosomes and diffuse neurofibroma (P<0.03). Compared with SN, NF-1 were also more frequently associated with melanocytic hyperplasia, lentigo simplex-like changes, diffuse neurofibroma and plexiform neurofibroma (P<0.001). Sebaceous hyperplasia (14%), dermal elastosis (9%), lipomatous change (8%), epithelial cysts (4%) and keratin granulomas or folliculitis (3%) were not significantly different in prevalence between NF-1, SN and the control group of IDN. CONCLUSIONS This study suggests that there is a difference in the potential for melanocytic proliferation in NF-1 compared with SN. NF-1, SN and IDN are associated with a similar range of incidental histologic changes. Ball NJ, Kho GT. Melanocytic nevi are associated with neurofibromas in neurofibromatosis, type 1, but not sporadic neurofibromas. A study of 226 cases.
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Affiliation(s)
- Nigel J Ball
- Department of Pathology, The University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada.
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Abstract
BACKGROUND There are numerous variants of cutaneous neurofibroma reflecting its manner of growth and histologic composition. Lipomatous neurofibroma is the latest described variant with only eight cases reported. METHODS A systematic study based on 320 consecutive specimens diagnosed of cutaneous neurofibroma was carried out. Conventional microscopy, immunohistochemistry, and statistical methods were used to determine the presence of fat cells, their amount, distribution, and frequency. RESULTS Intratumoral fat was observed in 22 (6.9%) neurofibromas. All these were dermal neurofibromas. Intraneoplastic fat was divided into two groups: focal and diffuse (regularly interspersed). Eighteen tumors (5.6%) presented adipocytes focally intermingled with the spindle cells. There were four (1.3%) neurofibromas showing spindle cell proliferation with regularly scattered adipocytes. Lipomatous neurofibroma was more frequent located on head and neck than non-lipomatous neurofibroma ( p = 0.04). Neurofibromas without mature adipocytes were more frequently immunoreactive for CD34 compared with tumors showing intratumoral fat ( p = 0.02). CONCLUSIONS We suggest that both metaplasia and aberrant adipose differentiation from multipotential cells may result in lipomatous neurofibroma. Focal presence of adipose cells may be attributable to metaplasia as the pathogenic mechanism. The fatty tissue being intrinsic to the tumor structure in its diffuse form, the lesion represents a distinctive tumor of the peripheral nerve sheath.
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Affiliation(s)
- J Fernando Val-Bernal
- Department of Anatomical Pathology, Marqués de Valdecilla University Hospital, University of Cantabria, Santander, Spain.
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Abstract
Three cases of a solitary neurofibroma showing focal fatty changes are reported. Fatty changes in a neurofibroma are rarely observed and have not been reported, and also, the pathogenesis of neurofibroma has not been clarified. We postulate that the fatty changes in a neurofibroma may be the result of so-called senescent change or chronic injury. The origin of adipose cells may be attributable to fatty infiltration from abutting tissues or to a metaplasia of tumor cells or resident fibroblasts.
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Affiliation(s)
- Sung Ku Ahn
- Department of Dermatology, Yonsei University Wonju College of Medicine, Wonju, Korea.
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