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Srivatsa S, Smith CJ, Sangüeza OP, Miedema J, Collichio FA, Googe PB. Lymphangitic Melanomatosis: Case Report of Intralymphatic Spread of Melanoma in a 66-year-old Man. Am J Dermatopathol 2024; 46:316-319. [PMID: 38574049 DOI: 10.1097/dad.0000000000002696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
ABSTRACT Melanoma with lymphatic invasion has been associated with increased risk of metastasis, but the mechanisms and clinical implications are poorly understood. Although current reports have documented angiotropic spread of melanoma and suggest lymphatic spread of melanoma to increase the likelihood of metastasis, to our knowledge, lymphangitic metastatic melanoma resembling cutaneous carcinomatosis or presenting with facial hyperpigmentation has not been described. In this case report, we describe extensive cutaneous intralymphatic spread of melanoma, or lymphangitic melanomatosis, producing macular skin pigmentation in a 66-year-old man.
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Affiliation(s)
- Shantanu Srivatsa
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Collin-Jamal Smith
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Omar P Sangüeza
- Department of Dermatology, School of Medicine, Wake Forest University, Winston-Salem, NC; and
| | - Jayson Miedema
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Frances A Collichio
- Division of Oncology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
| | - Paul B Googe
- Department of Dermatology, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC
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2
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Namubiru P, Dalleywater W, Lashin S, Elsheikh S. Can angiotropism and lymphovascular invasion refine the current cutaneous melanoma staging system? J Cutan Pathol 2024; 51:288-298. [PMID: 38100196 DOI: 10.1111/cup.14561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2023] [Revised: 09/29/2023] [Accepted: 10/30/2023] [Indexed: 03/05/2024]
Abstract
BACKGROUND Several prognostic factors for primary cutaneous melanoma (PCM) have been identified, and these predict metastasis and survival, to a certain extent. We sought to determine the frequency of angiotropism (AT) and lymphovascular invasion (LVI) in PCM and the relationship between AT, LVI, and other clinicopathological parameters and patient's prognosis. METHODS This study included 538 cases of PCM diagnosed between 2003 and 2016. It comprised 246 females and 292 males whose clinicopathological variables were evaluated with respect to LVI and AT using univariate and multivariate analyses. Overall survival (OS) was assessed by Kaplan-Meier (KM) analysis and Cox regression multivariate analysis. RESULTS AT occurred more frequently than LVI. Ulceration, mitotic rate, and Breslow thickness were found to be highly associated with both LVI and AT (p < 0.01). All LVI+ cases had AT, with a significant positive correlation (p < 0.01). Both AT and LVI predicted lymph node (LN) metastasis (odds ratio [OR] = 1.47, 1.12, respectively). Multivariate analysis showed LN metastasis, Breslow thickness, LVI, and AT as predictors of OS. LVI and AT independently predicted adverse OS by Cox regression analysis (hazard ratio [HR] = 1.66, 1.49, respectively) and with KM survival analysis. CONCLUSION AT is a marker for angiotropic extravascular migratory tumor spread (angiotropic EVMM), and LVI is a marker for intra-lymphovascular tumor spread. Both predict poor prognosis. Given its ease of detection, AT could be adopted as a histologpathological feature in the routine assessment of primary cutaneous malignant melanoma cases.
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Affiliation(s)
- Patricia Namubiru
- Faculty of Medicine and Health Sciences, School of Life Sciences, University of Nottingham, Nottingham, UK
| | - William Dalleywater
- Cellular Pathology Department, Nottingham University Hospital, Nottingham, UK
| | - Shaimaa Lashin
- Dermatology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, UK
| | - Somaia Elsheikh
- Cellular Pathology Department, Nottingham University Hospital, Nottingham, UK
- Division of Cancer and Stem Cells, School of Medicine, University of Nottingham, Nottingham, UK
- Histopathology Department, Faculty of Medicine, Menoufia University, Shibin El Kom, Egypt
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Ricci C, Dika E, Lambertini M, Ambrosi F, Grillini M, Chillotti S, Corradini AG, Veronesi G, Fiorentino M, Corti B. Hematoxylin and eosin or double stain for CD34/SOX10: Which is better for the detection of lymphovascular invasion in cutaneous melanoma? Pathol Res Pract 2022; 233:153876. [PMID: 35390633 DOI: 10.1016/j.prp.2022.153876] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2022] [Revised: 03/29/2022] [Accepted: 03/30/2022] [Indexed: 11/19/2022]
Abstract
BACKGROUND Lymphovascular invasion (LVI) is considered an unfavorable prognostic factor in cutaneous melanoma (CM). However, its detection by hematoxylin and eosin (H&E) is challenging, with discordant data about its association with clinical-pathological features and no previous studies investigating the inter- (IrOA) and intra-observer (IaOA) agreement. Herein, we tested H&E and double staining (DS) for CD34/SOX10 to detect the LVI in a cohort of 92 CMs, evaluating the IrOA, the IaOA, and the association with the other clinical-pathological features. METHODS Five authors independently evaluated 92 consecutive and retrospectively enrolled cases of CMs. We assessed the IrOA (Fleiss's Kappa/FK and intraclass correlation coefficient/ICC) and the IaOA (Cohen's Kappa/CK) with both H&E and CD34/SOX10. Furthermore, we compared the LVI assessment with the two stains and analyzed the association with other clinical-pathological features [χ2 tests for dichotomous and categorical data; Student t-test (normal distribution) and Mann-Whitney U-test (non-normal distribution) for continuous data]. RESULTS The IrOA was almost identical with H&E (FK=0.446; ICC=0.805) and CD34/SOX10 (FK=0.454; ICC=0.810); by contrast, the IaOA was higher with H&E for one pathologist (CK: 0.809) and with CD34/SOX10 for the other one (CK: 0.563). Applying previously defined criteria, LVI was detected in 10 (9.2%) and 11 (10.1%) cases with H&E and CD34/SOX10, respectively (p = 1.000). Both H&E and CD34/SOX10 were significantly associated with vertical growth phase (H&E, p: 0.014; CD34/SOX10, p: 0.010), mitosis ≥ 1/mm2 (H&E, p: 0.000; CD34/SOX10, p: 0.004), pT (H&E, p: 0.000; CD34/SOX10, p: 0.001), Breslow thickness (H&E, p: 0.000; CD34/SOX10, p: 0.001), and lymph node and/or distant metastasis (H&E, p: 0.005; CD34/SOX10, p: 0.000); only H&E was associated with ulceration (p: 0.002) and distant metastasis (p: 0.000), conversely, only CD34/SOX10 was associated with lymph node metastasis (p: 0.003). CONCLUSIONS CD34/SOX10 does not improve the IrOA and the IaOA of the LVI assessment in CM; furthermore, H&E and CD34/SOX10 show a similar profile of association with the other unfavorable clinical-pathological features of CM. As result, CD34/SOX10 could be a redundant diagnostic tool if applied for the prognostic characterization of not-selected CM in a routine diagnostic scenario.
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Affiliation(s)
- Costantino Ricci
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Emi Dika
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Martina Lambertini
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | | | - Marco Grillini
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Stefano Chillotti
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | | | - Giulia Veronesi
- Dermatology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
| | - Michelangelo Fiorentino
- Pathology Unit, Maggiore Hospital, AUSL Bologna, Bologna, Italy; Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy.
| | - Barbara Corti
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria Policlinico di Sant'Orsola, University of Bologna, Bologna, Italy
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Straker RJ, Taylor LA, Neuwirth MG, Sinnamon AJ, Shannon AB, Abbott J, Miura JT, Chu EY, Xu X, Karakousis GC. Optimizing Detection of Lymphatic Invasion in Primary Cutaneous Melanoma With the Use of D2-40 and a Paired Melanocytic Marker. Am J Dermatopathol 2022; 44:21-27. [PMID: 34231497 PMCID: PMC8671172 DOI: 10.1097/dad.0000000000002018] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
ABSTRACT Dual immunohistochemical (IHC) staining with D2-40 and S100 improves detection of lymphatic invasion (LI) in primary cutaneous melanoma. However, limited data exist evaluating this technique using other melanocytic markers, and thus, the optimal marker for detection of LI is unestablished. To address this knowledge gap, a case-control study was performed comparing melanoma specimens from 22 patients with known lymphatic spread (LS) with a control group of 11 patients without LS. Specimens underwent dual IHC staining with D2-40 and MART-1, SOX-10, and S100 to evaluate for LI. Receiver operating characteristic analysis was used to estimate each stain's accuracy for detection of LI. The LS group was more likely to be ≥65 years (P = 0.04), have a tumor thickness of ≥1 mm (P < 0.01), and have ulcerated tumors (P = 0.02). Detection of LI with D2-40/MART-1 significantly correlated with LS (P = 0.03), and the D2-40/MART-1 stain was most accurate for LI based on receiver operating characteristic curve analysis (area under the curve [AUC] 0.705) in comparison with D2-40/SOX-10 (AUC 0.575) and D2-40/S100 (AUC 0.633). These findings suggest that MART-1 may be the optimal melanocytic marker to combine with D2-40 for detection of LI in melanoma. Further studies are needed to determine the utility of routinely performing these stains for histopathologic analysis of melanoma.
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Affiliation(s)
- Richard J. Straker
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Laura A. Taylor
- Department of Dermatology, University of Louisville, Louisville, KY
| | | | | | - Adrienne B. Shannon
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - James Abbott
- Department of Dermatology, University of Utah, Salt Lake City, UT
| | - John T. Miura
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Emily Y. Chu
- Department of Dermatology, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Xiaowei Xu
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
| | - Giorgos C. Karakousis
- Department of Surgery, University of Pennsylvania, Perelman School of Medicine, Philadelphia, PA
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Fujimoto N, Dieterich LC. Mechanisms and Clinical Significance of Tumor Lymphatic Invasion. Cells 2021; 10:cells10102585. [PMID: 34685565 PMCID: PMC8533989 DOI: 10.3390/cells10102585] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2021] [Revised: 09/20/2021] [Accepted: 09/25/2021] [Indexed: 12/17/2022] Open
Abstract
Tumor-associated lymphatic vessels play an important role in tumor progression, mediating lymphatic dissemination of malignant cells to tumor-draining lymph nodes and regulating tumor immunity. An early, necessary step in the lymphatic metastasis cascade is the invasion of lymphatic vessels by tumor cell clusters or single tumor cells. In this review, we discuss our current understanding of the underlying cellular and molecular mechanisms, which include tumor-specific as well as normal, developmental and immunological processes “hijacked” by tumor cells to gain access to the lymphatic system. Furthermore, we summarize the prognostic value of lymphatic invasion, discuss its relationship with local recurrence, lymph node and distant metastasis, and highlight potential therapeutic options and challenges.
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Affiliation(s)
- Noriki Fujimoto
- Department of Dermatology, Shiga University of Medical Science, Otsu 520-2192, Japan;
| | - Lothar C. Dieterich
- Institute of Pharmaceutical Sciences, Swiss Federal Institute of Technology (ETH) Zurich, Vladimir-Prelog-Weg 1-5/10, 8093 Zurich, Switzerland
- Correspondence:
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Suresh R, Ziemys A, Holder AM. Dissecting the Lymphatic System to Predict Melanoma Metastasis. Front Oncol 2020; 10:576190. [PMID: 33330052 PMCID: PMC7729077 DOI: 10.3389/fonc.2020.576190] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 10/28/2020] [Indexed: 12/12/2022] Open
Abstract
Melanoma is the most lethal form of skin cancer in the United States. Current American Joint Committee on Cancer (AJCC) staging uses Breslow depth and ulceration as the two primary tumor factors that predict metastatic risk in cutaneous melanoma. Early disease stages are generally associated with high survival rates. However, in some cases, patients with thin melanomas develop advanced disease, suggesting other factors may contribute to the metastatic potential of an individual patient’s melanoma. This review focuses on the role of the lymphatic system in the metastasis of cutaneous melanoma, from recent discoveries in mechanisms of lymphangiogenesis to elements of the lymphatic system that ultimately may aid clinicians in determining which patients are at highest risk. Ultimately, this review highlights the need to integrate pathological, morphological, and molecular characteristics of lymphatics into a “biomarker” for metastatic potential.
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Affiliation(s)
- Rishi Suresh
- Texas A&M College of Medicine, Bryan, TX, United States
| | - Arturas Ziemys
- Department of Nanomedicine, Houston Methodist Research Institute, Houston, TX, United States
| | - Ashley M Holder
- Department of Surgery, Division of Surgical Oncology, University of Alabama at Birmingham, Birmingham, AL, United States
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7
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Guo YN, Tian DP, Gong QY, Huang H, Yang P, Chen SB, Billan S, He JY, Huang HH, Xiong P, Lin WT, Guo D, Marom M, Gil Z, Su M. Perineural Invasion is a Better Prognostic Indicator than Lymphovascular Invasion and a Potential Adjuvant Therapy Indicator for pN0M0 Esophageal Squamous Cell Carcinoma. Ann Surg Oncol 2020; 27:4371-4381. [PMID: 32519146 DOI: 10.1245/s10434-020-08667-4] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2020] [Indexed: 02/05/2023]
Abstract
BACKGROUND Esophageal squamous cell carcinoma (ESCC) at pN0M0 can be more locally aggressive and disseminated than those with lymph node and distant metastasis. Perineural invasion (PNI) is reported as a poor prognostic factor in cancer and is thought to be related to regional tumor spread and metastasis. However, its clinicopathological role and meaning for treatment in pN0M0 ESCC are unknown. PATIENTS AND METHODS We applied scoring methods of PNI and lymphatic and vascular invasion (LI, VI) based on immunohistochemistry staining on tumor tissues of pN0M0 ESCC patients. ROC analyses, Kaplan-Meier analyses, Cox regression, and χ2 test were performed for survival analysis, comparison of PNI with LI and VI, and exploration of the relevance between PNI and other clinicopathological features. RESULTS Presence of PNI was significantly associated with poor survival in pN0M0 patients, whereas LI and VI were not predictive of outcome (P > 0.05). Neural invasion index (NII), defined as the ratio of the number of tumor-invaded nerves to the total number of nerves per tumor microsection, was the most consistent measure of PNI (P = 0.006, HR = 6.892, 1.731-27.428). Postoperative radiotherapy significantly improved survival in high-NII patients (P = 0.035, HR = 0.390, 0.163-0.936). CONCLUSIONS PNI is an important risk factor for the outcome of pN0M0 ESCC patients. NII can be used for risk assessment and to tailor adjuvant radiotherapy in this population.
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Affiliation(s)
- Yuan-Ning Guo
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Dong-Ping Tian
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Qing-Yun Gong
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Hao Huang
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Peng Yang
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Shao-Bin Chen
- Department of Thoracic Surgery, Cancer Hospital of Shantou University Medical College, Shantou, China
| | - Salem Billan
- The Radiation Oncology Institute, The Head and Neck Center, Rambam Healthcare Campus, Haifa, Israel
| | - Jia-Yu He
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Hai-Hua Huang
- Department of Pathology, The Second Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Pan Xiong
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Wen-Ting Lin
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Dan Guo
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China
| | - Moshe Marom
- Guangdong Dynavolt Renewable Energy Technology, Shantou, China
| | - Ziv Gil
- The Laboratory for Applied Cancer Research, The Head and Neck Center, Department of Otolaryngology Head and Neck Surgery, Technion - Israel Institute of Technology, Haifa, Israel.
| | - Min Su
- Department of Pathology and Institute of Clinical Pathology, Shantou University Medical College, Shantou, China.
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8
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Moy AP, Duncan LM, Muzikansky A, Kraft S. Angiotropism in primary cutaneous melanoma is associated with disease progression and distant metastases: A retrospective study of 179 cases. J Cutan Pathol 2019; 46:498-507. [PMID: 30903664 DOI: 10.1111/cup.13461] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 03/15/2019] [Accepted: 03/19/2019] [Indexed: 02/06/2023]
Abstract
BACKGROUND Angiotropism is the histopathological correlate of pericytic mimicry and extravascular migratory metastasis (EVMM), a mechanism of melanoma spread by migration along the external surface of blood and lymphatic vessels. The frequency of angiotropism in primary cutaneous melanoma and the clinical utility of its detection remain unclear. METHODS We investigated angiotropism in 179 primary cutaneous melanomas by hematoxylin and eosin (H&E), CD31, and S100/D240 stains. RESULTS We detected angiotropism in 31 cases (17%) by H&E. CD31 immunohistochemistry increased detection to 59 cases (33%). When lymphatic vessels were included by using S100/D240 stains, 67 cases (37%) cases were positive. Angiotropism was associated with lymphatic invasion and mitotic rate with all detection methods. There was an association with increased tumor thickness when detected by H&E and CD31. No association with sentinel lymph node status was seen. By H&E and CD31 staining, angiotropism was associated with disease progression and distant metastases by univariate, but not multivariate analysis. Overall survival was not affected by the presence of angiotropism. CONCLUSIONS Angiotropism is relatively common in primary melanoma when immunohistochemical stains are used for detection and associated with mitotic rate and intravascular lymphatic invasion. The association with disease progression and distant metastasis suggests that it represents an alternative pathway of metastasis, that is, EVMM/pericytic mimicry vs intravascular spread.
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Affiliation(s)
- Andrea P Moy
- Pathology Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Department of Dermatology, Northwell Health and Zucker School of Medicine at Hofstra/Northwell, New York, New York
| | - Lyn M Duncan
- Pathology Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Alona Muzikansky
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Stefan Kraft
- Pathology Service, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
- Center for Dermatopathology, Freiburg, Germany
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9
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Moy AP, Mochel MC, Muzikansky A, Duncan LM, Kraft S. Lymphatic invasion predicts sentinel lymph node metastasis and adverse outcome in primary cutaneous melanoma. J Cutan Pathol 2017; 44:734-739. [PMID: 28555886 DOI: 10.1111/cup.12969] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2017] [Revised: 05/18/2017] [Accepted: 05/23/2017] [Indexed: 11/26/2022]
Abstract
BACKGROUND Sentinel lymph node (SLN) metastasis is a powerful predictor of survival in primary cutaneous melanoma. Lymphatic invasion (LI) may correlate with increased risk of SLN metastasis. Intralymphatic metastases, often difficult to detect on hematoxylin and eosin (H&E) stained sections, are readily identified with dual immunohistochemistry for melanocytic and lymphatic markers. METHODS We used dual S100/D240 immunohistochemistry to detect LI in 125 melanomas from patients who underwent SLN biopsy and correlated LI with melanoma staging parameters and disease status. RESULTS Dual immunohistochemistry allowed for the identification of LI in 33 cases (26%), compared to only 2% on H&E stained sections. Melanomas with LI showed greater thickness, higher mitotic rate and more frequent ulceration. Eleven of 33 cases with LI (33%) and 10 of 92 cases without LI (11%) were associated with a positive SLN (P = .006). More patients without LI were disease-free at last follow-up (80%) than patients with LI (50%; P = .002); LI was significantly associated with decreased progression-free survival. CONCLUSION The detection of LI is improved by dual immunohistochemistry and predicts SLN metastasis. The presence of LI may impact therapeutic planning in melanoma, such as the decision to perform a SLN biopsy.
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Affiliation(s)
- Andrea P Moy
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Mark C Mochel
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
- Department of Pathology, Virginia Commonwealth University, Richmond, Virginia
| | - Alona Muzikansky
- Biostatistics Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Lyn M Duncan
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
| | - Stefan Kraft
- Pathology Service, Massachusetts General Hospital, Boston, Massachusetts
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Arozarena I, Wellbrock C. Targeting invasive properties of melanoma cells. FEBS J 2017; 284:2148-2162. [PMID: 28196297 DOI: 10.1111/febs.14040] [Citation(s) in RCA: 31] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 01/26/2017] [Accepted: 02/10/2017] [Indexed: 02/11/2024]
Abstract
Melanoma is a skin cancer notorious for its metastatic potential. As an initial step of the metastatic cascade, melanoma cells part from the primary tumour and invade the surrounding tissue, which is crucial for their dissemination and the formation of distant secondary tumours. Over the last two decades, our understanding of both, general and melanoma specific mechanisms of invasion has significantly improved, but to date no efficient therapeutic strategy tackling the invasive properties of melanoma cells has reached the clinic. In this review, we assess the major contributions towards the understanding of the molecular biology of melanoma cell invasion with a focus on melanoma specific traits. These traits are based on the neural crest origin of melanoma cells and explain their intrinsic invasive nature. A particular emphasis is given not only to lineage specific signalling mediated by TGFβ, and noncanonical and canonical WNT signalling, but also to the role of PDE5A and RHO-GTPases in modulating modes of melanoma cell invasion. We discuss existing caveats in the current understanding of the metastatic properties of melanoma cells, as well as the relevance of the 'phenotype switch' model and 'co-operativity' between different phenotypes in heterogeneous tumours. At the centre of these phenotypes is the lineage commitment factor microphthalmia-associated transcription factor, one of the most crucial regulators of the balance between de-differentiation (neural crest specific gene expression) and differentiation (melanocyte specific gene expression) that defines invasive and noninvasive melanoma cell phenotypes. Finally, we provide insight into the current evidence linking resistance to targeted therapies to invasive properties of melanoma cells.
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Affiliation(s)
- Imanol Arozarena
- Cancer Signalling Group, Navarrabiomed (Miguel Servet Foundation), Instituto de Investigación Sanitaria de Navarra (IdiSNA), Pamplona, Spain
| | - Claudia Wellbrock
- Manchester Cancer Research Centre, Faculty of Biology, Medicine and Health, The University of Manchester, UK
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