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Alexandris D, Bobos M, Lallas A, Lazaridou E, Apalla Z. Clinical, dermatoscopic and histopathologic characteristics of tumoural melanosis: A case-series and literature review. J Eur Acad Dermatol Venereol 2024; 38:e428-e433. [PMID: 38059544 DOI: 10.1111/jdv.19657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023]
Affiliation(s)
- D Alexandris
- Department of Oncology, Evaggelismos General Hospital, Athens, Greece
| | - M Bobos
- Department of Biomedical Sciences, School of Health Sciences, International Hellenic University, Thessaloniki, Greece
| | - A Lallas
- First Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Lazaridou
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Z Apalla
- Second Dermatology Department, Aristotle University of Thessaloniki, Thessaloniki, Greece
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2
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Wix SN, Heberton M, Vandergriff TW, Yancey KB, Gill JG. Tumoral melanosis: A case series of patients with metastatic melanoma after systemic immunotherapy. JAAD Case Rep 2024; 45:82-87. [PMID: 38406620 PMCID: PMC10884798 DOI: 10.1016/j.jdcr.2024.01.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024] Open
Affiliation(s)
- Sophia N Wix
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Meghan Heberton
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Travis W Vandergriff
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Kim B Yancey
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Jennifer G Gill
- Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, Texas
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3
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Jurgens A, Guru S, Guo R, Brewer J, Bridges A, Jakub J, Comfere N. Tumoral Melanosis in the Setting of Targeted Immunotherapy for Metastatic Melanoma-A Single Institutional Experience and Literature Review. Am J Dermatopathol 2021; 43:9-14. [PMID: 32149829 DOI: 10.1097/dad.0000000000001612] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
BACKGROUND Tumoral melanosis clinically resembles metastatic melanoma, occurs in the context of regressed disease, and requires evaluation to rule out underlying melanoma and metastatic disease. Histopathology demonstrates a nodular infiltrate of melanophages in the dermis, subcutaneous tissue, deep soft tissue, or lymph nodes in the absence of viable melanocytes. Recent limited reports of tumoral melanosis in the context of immunotherapy with ipilimumab (monoclonal antibody targeting CTLA-4) as well as nivolumab and pembrolizumab (humanized monoclonal antibodies against programmed death 1 receptor) highlight a unique presentation representative of treatment-related tumor regression and an association with a favorable clinical response. OBJECTIVE To describe our experience with tumoral melanosis in the setting of immunotherapy for metastatic melanoma and elucidate the clinical and histopathological features. METHODS Retrospective case series from a single tertiary care institution. RESULTS We describe 10 cases of patients with metastatic melanoma who received treatment with immunotherapy before the development of tumoral melanosis. Length of time between the initiation of therapy and the onset of tumoral melanosis ranged from 2 to 20 months with a mean time of 10 months. At the end of the follow-up period, 8 patients were classified as having a complete or partial response to treatment with immunotherapy. One patient had progression of visceral and cutaneous disease on ipilimumab despite developing tumoral melanosis, and 1 patient had yet to undergo repeat imaging. Furthermore, at the end of follow-up, 3 patients were alive with no evidence of active disease, 5 patients were alive with disease, and 1 patient was deceased, although this patient died of a cardiovascular event unrelated to his underlying melanoma. Of the patients who were classified as alive with disease, 2 patients had minimal remaining disease, and 2 patients had an almost complete response on immunotherapy with recurrence of visceral metastases after immunotherapy was discontinued. One patient developed new peritoneal and cutaneous metastases on pembrolizumab despite development of tumoral melanosis. CONCLUSIONS The underlying biologic mechanisms and prognostic implications of tumoral melanosis in the setting of immunotherapy remain to be elucidated. Further prospective studies with a larger cohort and prolonged follow-up are necessary to better understand the incidence, prevalence, and oncologic outcomes in patients with tumoral melanosis who receive immunotherapy.
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Affiliation(s)
| | | | - Ruifeng Guo
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Alina Bridges
- Departments of Dermatology; and
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
| | | | - Nneka Comfere
- Departments of Dermatology; and
- Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN
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4
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Comparison of the Inflammatory Infiltrates in Tumoral Melanosis, Regressing Nevi, and Regressing Melanoma. Am J Dermatopathol 2019; 41:480-487. [PMID: 30601204 DOI: 10.1097/dad.0000000000001346] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Tumoral melanosis (TM) is a histologic diagnosis characterized by abundant pigment-laden macrophages in the dermis. It is generally thought to represent a regressed melanoma, although it has also been reported after benign pigmented lesions as well. Determining the antecedent lesion in cases of TM is of clinical importance to accurately guide therapy and prognostication. Comparing the histopathologic and immunohistochemical (IHC) characteristics of TM, halo nevi (HN), and regressing melanoma (RM) may help predict the antecedent lesion in cases of TM. METHODS Cases of TM, HN, and RM were selected and assessed for histopathologic (preservation of junctional melanocytic component, depth and width, solar elastosis, fibrosis, and preservation of rete ridge architecture) and IHC (SOX-10, CD138, and PD-1) parameters. PD-L1 immunostaining was also evaluated in cases of HN and RM. RESULTS Severe solar elastosis, fibrosis, and marked rete ridge effacement were more frequent in RM than in HN. By contrast, numerous plasma cells, clusters of lymphocytes expressing PD-1, and >50% PD-L1 expression in melanocytes were more common in HN than in RM. However, the association of these variables did not reach statistical significance. DISCUSSION Although studies with higher statistical power are needed, this study serves as an initial investigation to characterize the histopathologic and IHC characteristics, which may help better understand TM and its precursor lesions.
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Woodbeck R, Metelitsa AI, Naert KA. Granulomatous Tumoral Melanosis Associated With Pembrolizumab Therapy: A Mimicker of Disease Progression in Metastatic Melanoma. Am J Dermatopathol 2018; 40:523-526. [PMID: 29924748 DOI: 10.1097/dad.0000000000001066] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Immune checkpoint inhibitor therapy has revolutionized the treatment of advanced melanoma, with these agents significantly improving survival for patients with metastatic disease. With the increasing use of these agents, the number of adverse reactions secondary to their use has also increased. Sarcoidosis and sarcoid-like reactions are one such immune checkpoint inhibitor-related adverse event. We report a case of sarcoid-like granulomatous tumoral melanosis in a patient on the programmed cell death-1 (PD-1) receptor inhibitor pembrolizumab for metastatic melanoma. This is, to our knowledge, the first reported case of a sarcoidal form of tumoral melanosis in a patient on anti-PD-1 therapy. We postulate that this reflects tumor regression in response to pembrolizumab-induced immune activation, with concomitant therapy-triggered induction of a sarcoid-like reaction. These findings and the literature review presented herein should alert clinicians and pathologists to the possibility of regressed lesions with sarcoid-like features presenting as mimickers of disease progression in patients undergoing immunotherapy for advanced melanoma.
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Affiliation(s)
- Randi Woodbeck
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
| | - Andrei I Metelitsa
- Institute for Skin Advancement, Calgary, Alberta, Canada
- Division of Dermatology, University of Calgary, Calgary, Alberta, Canada
| | - Karen A Naert
- Department of Pathology and Laboratory Medicine, University of Calgary and Calgary Laboratory Services, Calgary, Alberta, Canada
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6
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Grohs RL, Mesbah Ardakani N. Melanoma Manifesting as Tumoral Melanosis; Now You See It, Now You Don't. Am J Dermatopathol 2018; 40:462-465. [PMID: 28291140 DOI: 10.1097/dad.0000000000000848] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- Robert L Grohs
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Australia
| | - Nima Mesbah Ardakani
- Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, Australia
- School of Pathology and Laboratory Medicine, University of Western Australia, Perth, Australia
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7
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Skala SL, Arps DP, Zhao L, Cha KB, Wang M, Harms PW, Andea AA, Fullen DR, Chan MP. Comprehensive histopathological comparison of epidermotropic/dermal metastatic melanoma and primary nodular melanoma. Histopathology 2018; 72:472-480. [PMID: 28881040 DOI: 10.1111/his.13384] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2017] [Accepted: 09/02/2017] [Indexed: 12/22/2022]
Abstract
AIMS Metastatic melanoma involving the epidermis and/or upper dermis may show significant histological overlap with primary cutaneous melanoma, especially the nodular subtype. Proper histopathological classification is crucial to appropriate staging and management, but is often challenging. The aim of this study was to identify helpful histopathological features for differentiating epidermotropic/dermal metastatic melanoma (EDMM) and primary nodular melanoma (PNM). METHODS AND RESULTS A cohort of EDMMs (n = 74) and PNMs (n = 75) was retrospectively reviewed for various histopathological features, and the data were compared between groups by the use of univariate analysis. Features significantly associated with EDMM included a tumour size of <2 mm, an absence of tumour-infiltrating lymphocytes and plasma cells, monomorphism, and involvement of adnexal epithelium. Features associated with PNM included a polypoid (exophytic) configuration, prominent tumour-infiltrating plasma cells (TIPs), a tumour size of >10 mm, ulceration, epidermal collarettes, a higher mitotic rate, necrosis, multiple phenotypes, significant pleomorphism, and lichenoid inflammation. In multivariate analysis, a logistic regression model including large tumour size, ulceration, prominent TIPs, lichenoid inflammation and epidermal collarettes was highly predictive of PNM. Six (8%) EDMMs from three patients showed an 'epidermal-only' or 'epidermal-predominant' pattern closely simulating in-situ or microinvasive melanoma. Two of these cases were tested by fluorescence in-situ hybridisation, which confirmed clonal relationships with their corresponding primary melanomas. CONCLUSIONS This is the first comprehensive histopathological comparison of EDMM and PNM. Recognition of the above histopathological associations should aid in the correct classification and staging of cutaneous melanoma. Epidermotropic metastatic melanomas may occasionally show an epidermal-only/epidermal-predominant pattern; accurate diagnosis requires prudent clinical correlation and, when necessary, ancillary molecular tests.
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Affiliation(s)
| | - David P Arps
- Consolidated Pathology Consultants, Libertyville, IL, USA
| | - Lili Zhao
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Kelly B Cha
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Min Wang
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - Paul W Harms
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Aleodor A Andea
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - Douglas R Fullen
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
| | - May P Chan
- Department of Pathology, University of Michigan, Ann Arbor, MI, USA
- Department of Dermatology, University of Michigan, Ann Arbor, MI, USA
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8
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Kato K, Namiki T, Nojima K, Hashimoto T, Ueno M, Hanafusa T, Miura K, Yokozeki H. Case of subungual tumoral melanosis: The detection of melanoma cells and dermoscopic features. J Dermatol 2017; 45:e161-e162. [PMID: 29265540 DOI: 10.1111/1346-8138.14188] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Kohei Kato
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takeshi Namiki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Kohei Nojima
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takashi Hashimoto
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Makiko Ueno
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Takaaki Hanafusa
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Keiko Miura
- Department of Pathology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
| | - Hiroo Yokozeki
- Department of Dermatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University, Tokyo, Japan
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Abstract
Tumoral melanosis is a form of completely regressed melanoma that usually presents as darkly pigmented lesions suspicious for malignant melanoma. Histology reveals dense dermal and subcutaneous infiltration of melanophages. Pembrolizumab is an antibody directed against programmed death receptor-1 (PD1) and is frontline treatment for advanced melanoma. An 81-year-old man with metastatic melanoma treated with pembrolizumab who developed tumoral melanosis at previous sites of metastases is described. The PubMed database was searched with the key words: antibody, immunotherapy, melanoma, melanosis, metastasis, pembrolizumab, and tumoral. The papers generated by the search and their references were reviewed. The patient was initially diagnosed with lentigo maligna melanoma on the left cheek three years earlier, and he was treated with wide local excision. The patient was subsequently diagnosed with epidermotropic metastatic malignant melanoma on the left parietal scalp 14 months later and was treated with wide local excision. Three months later, the patient was found to have metastatic melanoma in the same area of the scalp and was started on pembrolizumab immunotherapy. The patient was diagnosed with tumoral melanosis in the site of previous metastases nine months later. The patient remained free of disease 13 months after starting pembrolizumab. Tumoral melanosis may mimic malignant melanoma; hence a workup, including skin biopsy, should be undertaken. Extensive tumoral melanosis has been reported with ipilimumab, and we add a case following treatment with pembrolizumab. Additional cases of tumoral melanosis may present since immunotherapy has become frontline therapy for advanced melanoma.
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Affiliation(s)
- Omar Bari
- School of Medicine, University of California, San Diego
| | - Philip R Cohen
- Department of Dermatology, University of California, San Diego
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10
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Chan AH, Shulman KJ, Lee BA. Differentiating regressed melanoma from regressed lichenoid keratosis. J Cutan Pathol 2017; 44:338-341. [DOI: 10.1111/cup.12879] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 12/08/2016] [Accepted: 12/15/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Aegean H. Chan
- Division of DermatologyAlbert Einstein College of Medicine Bronx New York
| | | | - Bonnie A. Lee
- Division of DermatologyAlbert Einstein College of Medicine Bronx New York
- Ackerman Academy of DermatopathologyDermpath Diagnostics New York New York
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11
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Tan WP, Yeo B, Chia HY, Cheng S, Heng YK, Lee J. Vitiligo and tumoral melanosis: signs of metastasis in a patient with melanoma. Clin Exp Dermatol 2016; 41:924-926. [PMID: 27774636 DOI: 10.1111/ced.12924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/22/2015] [Indexed: 11/26/2022]
Affiliation(s)
- W P Tan
- National Skin Centre, Singapore
| | - B Yeo
- National Skin Centre, Singapore
| | | | - S Cheng
- National Skin Centre, Singapore
| | | | - J Lee
- National Skin Centre, Singapore
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12
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Staser K, Chen D, Solus J, Rosman IS, Schaffer A, Cornelius L, Linette GP, Fields RC. Extensive tumoral melanosis associated with ipilimumab-treated melanoma. Br J Dermatol 2016; 175:391-3. [PMID: 26877232 DOI: 10.1111/bjd.14474] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/04/2016] [Indexed: 11/29/2022]
Abstract
Tumoral melanosis describes a pigmented lesion clinically similar to melanoma but on histology reveals dense aggregates of melanin-laden, benign macrophages without malignant cells. In the few reported cases so far, tumoral melanosis has arisen in the skin or lymph node of a patient with a regressed melanoma or an epithelioid tumour. As a marker of regressed primary melanoma, its discovery may prompt investigation and surveillance for undiagnosed local or metastatic disease. Here, we present a unique case of extensive tumoral melanosis arising during ipilimumab treatment of in-transit metastases from a previously excised melanoma.
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Affiliation(s)
- K Staser
- Division of Dermatology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - D Chen
- Division of Dermatology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - J Solus
- Division of Dermatology, Washington University in St. Louis, St. Louis, MO, U.S.A.,Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - I S Rosman
- Division of Dermatology, Washington University in St. Louis, St. Louis, MO, U.S.A.,Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - A Schaffer
- Division of Dermatology, Washington University in St. Louis, St. Louis, MO, U.S.A.,Department of Pathology and Immunology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - L Cornelius
- Division of Dermatology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - G P Linette
- Division of Hematology and Oncology, Washington University in St. Louis, St. Louis, MO, U.S.A
| | - R C Fields
- Department of Surgery, Washington University in St. Louis, St. Louis, MO, U.S.A
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Dogruk Kacar S, Ozuguz P, Karaca S, Aktepe F. Tumoral melanosis in an adolescent after trauma: a clinicopathological dilemma. Pediatr Dermatol 2014; 31:e69-70. [PMID: 24274989 DOI: 10.1111/pde.12268] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Tumoral melanosis (TM) is a histologic term used to indicate a nodular accumulation of melanophages in the dermis clinically presenting as a pigmented lesion. It is usually associated with regression of melanoma and nonmelanoma melanocytic pigmented lesions. We present the case of a 16-year-old girl with a suspicious pigmented macule on her right knee that appeared after trauma. The lesion was completely excised and diagnosed as TM.
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Affiliation(s)
- Seval Dogruk Kacar
- Department of Dermatology, School of Medicine, Afyon Kocatepe University, Afyonkarahisar, Turkey
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14
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Lymph Node Melanosis From a Primary Cutaneous Lesion Combining a Nodular (Tumoral) Melanosis and a Congenital Dermal Melanocytic Nevus. Am J Dermatopathol 2012; 34:653-7. [DOI: 10.1097/dad.0b013e3182447f73] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Speeckaert R, van Geel N, Vermaelen KV, Lambert J, Van Gele M, Speeckaert MM, Brochez L. Immune reactions in benign and malignant melanocytic lesions: lessons for immunotherapy. Pigment Cell Melanoma Res 2010; 24:334-44. [DOI: 10.1111/j.1755-148x.2010.00799.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Malafronte P, Sorrells T. Lymph node melanosis in a patient with metastatic melanoma of unknown primary. Arch Pathol Lab Med 2009; 133:1332-4. [PMID: 19653733 DOI: 10.5858/133.8.1332] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/08/2008] [Indexed: 11/06/2022]
Abstract
Tumoral or nodular melanosis in the skin is considered a variation of completely regressed melanoma, presenting clinically as a suspicious pigmented papule or nodule. Microscopically, the lesion consists of a nodular accumulation of heavily pigmented melanophages in the dermis, staining positive for immunohistochemical markers of histiocytic lineage (CD68) and negative for those of melanocytic lineage (S100, HMB-45, Melan-A). This process is rarely described in lymph nodes. We present a report of a patient with melanosis involving multiple lymph nodes of an axillary dissection, done for metastatic melanoma with an unknown primary, and discuss possible prognostic and treatment factors.
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Affiliation(s)
- Patrick Malafronte
- Department of Pathology and Laboratory Services, National Naval Medical Center, 8901 Wisconsin Ave, Bethesda, MD 20889-5600, USA.
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19
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Massi G. Melanocytic nevi simulant of melanoma with medicolegal relevance. Virchows Arch 2007; 451:623-47. [PMID: 17653760 DOI: 10.1007/s00428-007-0459-7] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2007] [Revised: 06/15/2007] [Accepted: 06/18/2007] [Indexed: 10/23/2022]
Abstract
A group of melanocytic benign nevi are prone to be misdiagnosed as nodular or superficial spreading melanoma. This review illustrates the most frequent forms of these nevi in direct comparison with their malignant morphologic counterparts. The nevi are: hyper-cellular form of common nevus to be distinguished from nevoid melanoma, Spitz nevus (vs spitzoid melanoma), Reed nevus (vs melanoma with features of Reed nevus), cellular atypical blue nevus (vs melanoma on blue nevus), acral nevus (vs acral melanoma), Clark dysplastic nevus (vs superficial spreading melanoma), desmoplastic nevi (vs desmoplastic melanoma), benign proliferative nodules in congenital nevi (vs melanoma on congenital nevi), epithelioid blue nevus (vs animal type melanoma) and regressed nevus (vs regressed melanoma). For each single 'pair' of morphological look-alikes, a specific set of morphological, immunohistochemical and genetic criteria is provided.
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Affiliation(s)
- Guido Massi
- Department of Pathology, Catholic University Medical School, Largo F. Vito, 1, 00168, Rome, Italy.
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