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Lezcano C, Jungbluth AA, Busam KJ. Immunohistochemistry for PRAME in Dermatopathology. Am J Dermatopathol 2023; 45:733-747. [PMID: 37856737 PMCID: PMC10593485 DOI: 10.1097/dad.0000000000002440] [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] [Indexed: 10/21/2023]
Abstract
ABSTRACT Preferentially expressed antigen in melanoma (PRAME) is a tumor-associated antigen first identified in a melanoma patient and found to be expressed in most melanomas as well as in variable levels in other malignant neoplasms of epithelial, mesenchymal, or hematolymphoid lineage. Detection of PRAME expression in formalin-fixed paraffin-embedded tissue is possible by immunohistochemistry (IHC) with commercially available monoclonal antibodies. In situ and invasive melanoma frequently show a diffuse pattern of nuclear PRAME immunoreactivity which contrasts with the infrequent and typically nondiffuse staining seen in nevi. In many challenging melanocytic tumors, results of PRAME IHC and other ancillary tests correlate well, but not always: The tests are not interchangeable. Most metastatic melanomas are positive for PRAME, whereas nodal nevi are not. Numerous studies on PRAME IHC have become available in the past few years with results supporting the value of PRAME IHC as an ancillary tool in the evaluation of melanocytic lesions and providing insights into limitations in sensitivity and specificity as well as possible pitfalls that need to be kept in mind by practicing pathologists.
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Affiliation(s)
- Cecilia Lezcano
- Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Achim A Jungbluth
- Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - Klaus J Busam
- Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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2
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Kretschmer L, Schnabel V, Kromer C, Bauer-Büntzel C, Richter A, Bremmer F, Kück F, Julius K, Mitteldorf C, Schön MP. Melanocytic nevi in sentinel lymph nodes: association with cutaneous nevi and clinical relevance in patients with cutaneous melanomas. J Cancer Res Clin Oncol 2022; 148:3125-3134. [PMID: 35059868 PMCID: PMC9508010 DOI: 10.1007/s00432-021-03894-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2021] [Accepted: 12/19/2021] [Indexed: 10/26/2022]
Abstract
PURPOSE Melanocytic nevi in lymph nodes (NNs) are an important histological differential diagnosis of initial sentinel lymph node (SN) metastasis in melanoma. Our aim was to associate NN in SNs with clinicopathologic features and survival rates in 1, 250 patients with SN biopsy for melanoma. METHODS To compare patients with present and absent NN, we used Fisher's exact test, Mann-Whitney U test, and multivariate logistic regression models in this retrospective observational study based on a prospectively maintained institutional database. RESULTS NN prevalence in axillary, cervical, and groin SNs was 16.5%, 19.4%, and 9.8%, respectively. NN were observed in combination with all growth patterns of melanoma, but more frequently when the primary was histologically associated with a cutaneous nevus. We observed a decreasing NN prevalence with increasing SN metastasis diameter. Multiple logistic regression determined a significantly increased NN probability for SNs of the neck or axilla, for individuals with ≥ 50 cutaneous nevi, midline primary melanomas, and for individuals who reported non-cutaneous malignancies in their parents. Cancer in parents was also significantly more frequently reported by melanoma patients who had more than 50 cutaneous nevi. In SN-negative patients, NN indicated a tendency for slightly lower melanoma-specific survival. CONCLUSIONS We found a highly significant association between NN diagnosis and multiple cutaneous nevi and provided circumstantial evidence that cutaneous nevi in the drainage area of lymph nodes are particularly important. The trend toward lower melanoma-specific survival in SN-negative patients with NN suggests that careful differentiation of SN metastases is important.
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Affiliation(s)
- Lutz Kretschmer
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany.
| | - Viktor Schnabel
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Christian Kromer
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Christoph Bauer-Büntzel
- Department of Nephrology and Hypertension, Center for Internal Medicine and Medical Clinic III, Klinikum Fulda, Fulda, Germany
| | - Annika Richter
- Institute of Pathology, University Medical Center, Göttingen, Germany
| | - Felix Bremmer
- Institute of Pathology, University Medical Center, Göttingen, Germany
| | - Fabian Kück
- Department of Medical Statistics, University Medical Center, Göttingen, Germany
| | - Katharina Julius
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Christina Mitteldorf
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
| | - Michael P Schön
- Department of Dermatology, Venereology and Allergology, University Medical Center, Robert Koch Str. 40, 37075, Göttingen, Germany
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3
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Jahnke MN, O'Haver J, Gupta D, Hawryluk EB, Finelt N, Kruse L, Jen M, Horii KA, Frieden IJ, Price H, Coughlin CC. Care of Congenital Melanocytic Nevi in Newborns and Infants: Review and Management Recommendations. Pediatrics 2021; 148:183438. [PMID: 34845496 DOI: 10.1542/peds.2021-051536] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/03/2021] [Indexed: 01/06/2023] Open
Abstract
A pediatric dermatology expert working group performed a narrative review to describe care related to congenital melanocytic nevi (CMN) in neonates and infants. There are no published guidelines for most aspects of care, including routine skin care and visit intervals. Few guidelines exist for surgical management; newer recommendations favor conservative practice. Emerging evidence contributes to recommendations for screening MRI to evaluate for neural melanosis and related central nervous system complications, however, more research is needed. Risk for melanoma is generally low, but those with large, giant, or multiple CMN have a higher risk. Multidisciplinary care, with a focus on family and patient preferences, is of paramount importance. Without standardized screening and management guidelines, questions abound regarding appropriate physical examination intervals, potential treatment including full or partial excision, timing and frequency of imaging, melanoma risk, and assessment for neural melanosis. This review highlights the current state of knowledge concerning care of patients with CMN, reveals gaps in the literature surrounding skin care, and provides management recommendations. We additionally discuss cutaneous complications of CMN, such as pruritus, hypertrichosis, and wound healing. Resources and references for families and providers can help patients navigate this sometimes challenging diagnosis. Finally, we contribute expert care recommendations to the current body of literature as a foundation for the development of future, more comprehensive care guidelines.
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Affiliation(s)
- Marla N Jahnke
- Department of Dermatology, Henry Ford Health System, Detroit, Michigan
| | - Judith O'Haver
- Division of Dermatology, Phoenix Children's Hospital and College of Medicine, University of Arizona-Phoenix, Phoenix, Arizona
| | - Deepti Gupta
- Division of Dermatology, Seattle Children's Hospital, Seattle, Washington
| | - Elena B Hawryluk
- Department of Dermatology, Harvard Medical School, Boston, Massachusetts
| | - Nika Finelt
- Department of Dermatology, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, New Hyde Park, New York
| | - Lacey Kruse
- Division of Dermatology, Lurie Children's Hospital and Feinberg School of Medicine, Northwestern University, Chicago, Illinois
| | - Melinda Jen
- Section of Pediatric Dermatology, Department of Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Kimberly A Horii
- Division of Dermatology, Children's Mercy-Kansas City, Kansas City, Missouri
| | - Ilona J Frieden
- Departments of Dermatology and Pediatrics, School of Medicine, University of California, San Francisco, San Francisco, California
| | - Harper Price
- Division of Dermatology, Phoenix Children's Hospital and College of Medicine, University of Arizona-Phoenix, Phoenix, Arizona
| | - Carrie C Coughlin
- Division of Dermatology, Departments of Medicine and Pediatrics, School of Medicine, Washington University in St Louis, St Louis, Missouri
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4
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Lezcano C, Jungbluth AA, Busam KJ. PRAME Immunohistochemistry as an Ancillary Test for the Assessment of Melanocytic Lesions. Surg Pathol Clin 2021; 14:165-175. [PMID: 34023098 DOI: 10.1016/j.path.2021.01.001] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PRAME (PReferentially expressed Antigen in MElanoma) is a melanoma-associated antigen expressed in cutaneous and ocular melanomas and some other malignant neoplasms, while its expression in normal tissue and benign tumors is limited. Detection of PRAME protein expression by immunohistochemistry in a cohort of 400 melanocytic tumors showed diffuse nuclear immunoreactivity for PRAME in most metastatic and primary melanomas. In contrast, most nevi were negative for PRAME or showed nondiffuse immunoreactivity. The difference in the extent of immunoreactivity for PRAME in unambiguous melanocytic tumors prompted the study of PRAME as an ancillary tool for evaluating melanocytic lesions in more challenging scenarios.
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Affiliation(s)
- Cecilia Lezcano
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA.
| | - Achim A Jungbluth
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY, USA
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5
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Assenmacher CA, Santagostino SF, Oyama MA, Marine JC, Bonvin E, Radaelli E. Classification and Grading of Melanocytic Lesions in a Mouse Model of NRAS-driven Melanomagenesis. J Histochem Cytochem 2020; 69:203-218. [PMID: 33283624 DOI: 10.1369/0022155420977970] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
The mouse line carrying the Tg(Tyr-NRAS*Q61K)1Bee transgene is widely used to model in vivo NRAS-driven melanomagenesis. Although the pathological features of this model are well described, classification and interpretation of the resulting proliferative lesions-including their origin, evolution, grading, and pathobiological significance-are still unclear and not supported by molecular and biological evidence. Focusing on their classification and grading, this work combines histopathology and expression analysis (using both immunohistochemistry [IHC] and quantitative PCR) of selected biomarkers to study the full spectrum of cutaneous and lymph nodal melanocytic proliferations in the Tg(Tyr-NRAS*Q61K)1Bee mouse. The analysis of cutaneous and lymph nodal melanocytic proliferations has demonstrated that a linear correlation exists between tumor grade and Ki-67, microphthalmia-associated transcription factor (MITF), gp100, and nestin IHC, with a significantly increased expression in high-grade lesions compared with low-grade lesions. The accuracy of the assessment of MITF IHC in melanomas was also confirmed by quantitative PCR analysis. In conclusion, we believe the incorporation of MITF, Ki-67, gp100, and nestin analysis into the histopathological classification/grading scheme of melanocytic proliferations described for this model will help to assess with accuracy the nature and evolution of the phenotype, monitor disease progression, and predict response to experimental treatment or other preclinical manipulations.
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Affiliation(s)
| | | | - Mark A Oyama
- Department of Clinical Sciences and Advanced Medicine, School of Veterinary Medicine, University of Pennsylvania, Philadelphia, PA.,Institute for Translational Medicine and Therapeutics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | | | - Elise Bonvin
- Laboratory of Cancer Epigenetics, Cancer Research Center, Université Libre de Bruxelles, Brussels, Belgium
| | - Enrico Radaelli
- Department of Pathobiology, University of Pennsylvania, Philadelphia, PA
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Hu J, Ren M, Cai X, Zhang Y, Lv JJ, Kong YY. Nevus cell aggregates massively occupying parenchyma of an external iliac lymph node: A case report and review of the literature. J Cutan Pathol 2020; 47:1175-1180. [PMID: 32644206 DOI: 10.1111/cup.13805] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2020] [Revised: 06/30/2020] [Accepted: 07/01/2020] [Indexed: 11/28/2022]
Abstract
We report a case of nevus cell aggregates (NCAs) in an external iliac lymph node from a patient with a compound congenital nevus in the corresponding drainage skin. Melanocytes in parenchyma were in band, nest-like or nodular fashion, and partly continuous with those in capsule and trabeculae. The largest nodule in parenchyma measured 6.5 mm. Melanocytes mostly exhibited benign appearance identical to cutaneous nevus. A few regions abundant in cells displayed atypical features, including increased nucleo-cytoplasmic ratio, small nucleoli, and occasional mitotic figures. Immunohistochemistry showed that melanocytes stained positive for p16, but negative for HMB-45 and nestin. Ki-67 labeling was less than 1% and reticulin mainly surrounded individual melanocytes. Besides, Vysis melanoma fluorescence in situ hybridization (FISH) plus another 2 probes targeting 9p21(CDKN2A) and 8q24(MYC) showed normal results. The patient is alive without malignant tumor after 52-month follow up. Our case provides a new evidence for the existence of intraparenchymal NCAs in deep lymph node and indicates that melanocytes with some atypical features can occur in nodal nevi. Nevus cells in parenchyma connected to those in capsule and trabeculae are a significant clue to distinguish nodal nevi from metastatic melanomas. Additionally, immunohistochemistry and FISH assay are useful in differential diagnosis.
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Affiliation(s)
- Jue Hu
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Min Ren
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Xu Cai
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yan Zhang
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Jiao-Jie Lv
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
| | - Yun-Yi Kong
- Department of Pathology, Fudan University Shanghai Cancer Center, Shanghai, People's Republic of China
- Department of Oncology, Shanghai Medical College, Fudan University, Shanghai, People's Republic of China
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7
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Cao Y, Yang X, Lai YM, Jia L, Diao XT, Zhuang Q, Lin DM. Genetic investigation of nodal melanocytic nevi in cases of giant congenital melanocytic nevus. Histol Histopathol 2020; 35:1151-1157. [PMID: 32729623 DOI: 10.14670/hh-18-243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Nodal melanocytic nevi are common incidental findings in lymph nodes that have been removed during sentinel lymph node biopsy for melanoma. They can also occur in the local lymph nodes of the giant congenital nevus (GCN), but very little is known regarding nodal melanocytic nevi in the giant congenital nevus, especially at the genetic level. There are two theories that explain the possible pathogenesis of nodal melanocytic nevi, mechanical transport and arrested migration during embryogenesis. However, there have been few tests of these two theories at the molecular biology level until now. We used whole-exon sequencing to test these two theories at the gene level for the first time. In clonal evolution analysis of patient 1, whose tumor mutation burden (TMB) value was relatively stable, showed that the GCN and nodal nevus had the same initial origin and then diverged into two branches as a result of gene mutations. In contrast, analysis indicated that in the other patient, whose TMB value declined from 68.02/Mb in a GCN to 17.55/Mb in associated nodal nevi, these two samples were from different origins at the beginning, each with its own gene mutation. These results are consistent with the two respective theories at the molecular biological level. We provided the first tests of the two theories of pathogenesis of nodal melanocytic nevi at the gene level, and these findings may provide some clues for further study. In addition, not all nodal nevi should be treated as lymph node metastasis in clinical diagnosis, and we should make a comprehensive assessment and judgment of nodal melanocytic nevi based on morphology, immunological characteristics and fluorescence in situ hybridization (FISH) tests.
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Affiliation(s)
- Y Cao
- Department of Phatology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - X Yang
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Y-M Lai
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - L Jia
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - X-T Diao
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China
| | - Q Zhuang
- Department of Pathology, Plastic Surgery Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, PR China
| | - D-M Lin
- Department of Pathology, Key laboratory of Carcinogenesis and Translational Research (Ministry of Education), Peking University Cancer Hospital and Institute, Beijing, China.
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8
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Immunohistochemistry for PRAME in the Distinction of Nodal Nevi From Metastatic Melanoma. Am J Surg Pathol 2020; 44:503-508. [PMID: 31633488 DOI: 10.1097/pas.0000000000001393] [Citation(s) in RCA: 67] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The distinction of metastatic melanoma from melanocytic nevi in lymph nodes can on occasion be difficult. As diffuse immunohistochemical (IHC) PRAME (PReferentially expressed Antigen in MElanoma) expression is detected in the majority of primary and metastatic melanomas, but rarely in nevi, we reasoned that PRAME could be a useful adjunct marker for the diagnosis of melanocytes in lymph nodes. In this study, we examined 45 nodal melanocytic deposits comprising 30 nodal nevi and 15 melanoma metastases. The latter were diagnostically not straightforward because they either coexisted with nodal nevi or were present in perinodal fibrous tissue. All nodal nevi (30/30) were negative for PRAME, whereas all melanoma metastases (15/15) were diffusely positive for PRAME IHC. We additionally report the novel use of a PRAME/Melan A dual-label immunostain. Our results show that PRAME IHC may be useful in the assessment of diagnostically challenging nodal melanocytic deposits, such as intraparenchymal nodal nevi, metastases confined to the capsular fibrous tissue, or in the setting of small metastases coexisting with a nodal nevus in the same lymph node.
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9
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Yamashita TS, Pockaj BA, Bagaria SP, Flotte TJ, Fahy AS, de Azevedo RU, Harmsen WS, Block MS, Jakub JW. Clinical significance of SLN benign capsular nevi in patients with melanoma. J Surg Oncol 2020; 122:1043-1049. [PMID: 33616952 DOI: 10.1002/jso.26135] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 07/07/2020] [Accepted: 07/09/2020] [Indexed: 11/09/2022]
Abstract
BACKGROUND Benign capsular nevi (BCN) are not infrequent in sentinel lymph nodes (SLN) of patients with melanoma. Their prognostic significance is unknown and the literature is limited. This study evaluated the clinical significance of incidentally found BCN in these patients. METHODS A multi-institutional retrospective review of patients undergoing SLN biopsy for cutaneous melanoma between 2000 and 2016. Patients were divided into the following groups: (a) negative SLN and no BCN, (b) negative SLN and presence of BCN, (c) positive SLN seen only on immunohistochemistry (IHC), and (d) positive SLN via hematoxylin and eosin (H&E). Outcomes measured were overall survival and any recurrence. RESULTS A total of 1253 patients were identified (group 1 = 978, group 2 = 56, group 3 = 32, and group 4 = 187). Fifty-seven percent were male and the mean age was 59.3 years. BCN was identified in 77 patients (6.2%), of which the majority was in the node-negative group (72%). Multivariable analysis showed that BCN was associated with lower recurrence rates, though not statistically significant (hazard ratio [HR] = 0.5; P = .06). IHC- and H&E-positive SLNs were associated with a higher risk of recurrence (HR = 2.4; P = .02 and 2.0, P < .0001, respectively). CONCLUSION Patients with BCN and negative SLN had lower recurrence rates than patients with negative SLN and no BCN. Our data suggest a possible protective effect against recurrence.
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Affiliation(s)
| | | | | | - Thomas J Flotte
- Department of Anatomic Pathology, Mayo Clinic, Rochester, Minnesota
| | | | | | - William S Harmsen
- Department of Clinical Statistics, Mayo Clinic, Rochester, Minnesota
| | - Matthew S Block
- Department of Medical Oncology, Mayo Clinic, Rochester, Minnesota
| | - James W Jakub
- Department of Surgery, Mayo Clinic, Rochester, Minnesota
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10
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Spitz Nevus and Other Spitzoid Tumors in Children. Part 2: Cytogenetic and Molecular Features. Prognosis and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2020. [DOI: 10.1016/j.adengl.2019.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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11
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Sainz-Gaspar L, Sánchez-Bernal J, Noguera-Morel L, Hernández-Martín A, Colmenero I, Torrelo A. Spitz Nevus and Other Spitzoid Tumors in Children. Part 2: Cytogenetic and Molecular Features. Prognosis and Treatment. ACTAS DERMO-SIFILIOGRAFICAS 2019; 111:20-25. [PMID: 31739993 DOI: 10.1016/j.ad.2019.02.010] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Accepted: 02/03/2019] [Indexed: 12/25/2022] Open
Abstract
Melanocytic neoplasms with spitzoid morphology (Spitz nevi, atypical Spitz tumors, and spitzoid melanomas) may be benign or malignant. Because the malignant potential of atypical Spitz tumors is uncertain, the proper therapeutic approach has been much debated over the years. Promising new techniques for molecular analysis have enabled better predictions of the biological behavior of these tumors. We review their cytogenetic features and prognosis and also provide an update of the most recent recommendations for management.
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Affiliation(s)
- L Sainz-Gaspar
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - J Sánchez-Bernal
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - L Noguera-Morel
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - A Hernández-Martín
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - I Colmenero
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España
| | - A Torrelo
- Servicio de Dermatología y Anatomía Patológica, Hospital Infantil Universitario del Niño Jesús, Madrid, España.
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Small and Isolated Immunohistochemistry-positive Cells in Melanoma Sentinel Lymph Nodes Are Associated With Disease-specific and Recurrence-free Survival Comparable to that of Sentinel Lymph Nodes Negative for Melanoma. Am J Surg Pathol 2019; 43:755-765. [DOI: 10.1097/pas.0000000000001229] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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13
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Stone CA. Malignant melanoma: Claims and controversies. JOURNAL OF PATIENT SAFETY AND RISK MANAGEMENT 2018. [DOI: 10.1177/2516043518793786] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Malignant melanoma is a common cancer in young people and its incidence is rising in the UK. The management of the disease is evolving, with new approaches to the treatment of locally advanced and systemic disease in particular being rapidly developed. Sentinel node biopsy is a valuable treatment option for the staging of melanoma, and completion lymphadenectomy in node-positive patients improves local disease control. However, early clearance of occult microscopic nodal disease has not been proven to confer a melanoma-specific survival advantage. Delays in the diagnosis and treatment of melanoma lead to claims being brought in negligence, but establishing causation in such cases can be difficult.
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Affiliation(s)
- Christopher A Stone
- Royal Devon and Exeter NHS Foundation Trust and Exeter Medical Ltd, Exeter, UK
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14
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Abstract
The acquired melanocytic nevus is the most common lesion encountered by pediatric pathologists and dermatopathologists in their daily practice. In most cases, there are few difficulties in histopathologic diagnosis. However, it is the acquired melanocytic lesion known as the Spitz nevus, with its intrinsic atypical features which becomes the challenge since it exists along a histopathologic and biologic continuum from the atypical Spitz tumor to spitzoid melanoma. The frustration with some of these spitzoid lesions is that even the "experts" cannot agree as to the differentiation of one from the other even at the level of molecular genetics. Other melanocytic lesions are discussed including the congenital melanocytic nevus with its proliferative nodule(s) and melanoma as the ultimate complication. Although uncommon, cutaneous melanoma in the first 2 decades is emerging as a clinical problem especially in young women in the second decade of life. These are ultraviolet-associated neoplasms whose histopathologic and prognostic features are identical to the adult experience. Considerable progress has been made over the past 15 to 20 years in our understanding of cutaneous melanocytic lesions, but gaps still exist in the important group of spitzoid lesions. It can also be anticipated that more cutaneous melanomas in children will be seen in the future based upon epidemiologic studies.
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Affiliation(s)
- Chen Yang
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri
| | - Alejandro A Gru
- 2 Department of Pathology, University of Virginia, Charlottesville, Virginia
| | - Louis P Dehner
- 1 Lauren V. Ackerman Laboratory of Surgical Pathology, St. Louis Children's Hospital, Washington University Medical Center, St. Louis, Missouri
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Lymph nodes’ capsular naevi are associated with high naevus count in melanoma patients: a case–control study. Melanoma Res 2017; 27:274-276. [DOI: 10.1097/cmr.0000000000000328] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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