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Archives of Pathology & Laboratory... Jul 2011Acral lentiginous melanoma is the most prevalent clinical presentation of melanoma in ethnic groups other than whites and also occurs in significant numbers in North... (Review)
Review
CONTEXT
Acral lentiginous melanoma is the most prevalent clinical presentation of melanoma in ethnic groups other than whites and also occurs in significant numbers in North America and Europe. Despite a clear-cut clinical picture, histologic findings seen in partial biopsies may be too subtle and deceive pathologists dealing with such cases.
OBJECTIVES
To make pathologists aware of the histologic findings during early phases of acral lentiginous melanoma (including the in situ phase), to compare those findings with what is seen in acral junctional nevus, and to highlight their similarities and differences. This review will also emphasize the important clinical and dermatoscopic findings to be considered when diagnosing acral lentiginous melanoma.
DATA SOURCES
Review of published articles on the epidemiology; the clinical, dermatoscopic, and histopathologic findings; and the molecular biology of acral lentiginous melanoma as well as the personal experience of the authors when dealing with such cases.
CONCLUSIONS
Acral lentiginous melanoma is a clinicopathologic entity with a clear-cut clinical picture: a diameter larger than 0.7 mm; ill-defined, darkly pigmented, flat lesion with irregular borders on acral locations; and the presence of mostly single-cell proliferations of melanocytes along the dermo-epidermal junction. Along with a few additional criteria, these findings should be sufficient to allow the pathologist to make the diagnosis and to recommend complete excision. Fluent communication between clinician and pathologist will facilitate a correct diagnosis.
Topics: Diagnosis, Differential; Humans; Hutchinson's Melanotic Freckle; Nevus, Pigmented; Prevalence; Skin Neoplasms
PubMed: 21732773
DOI: 10.5858/2010-0323-RAR.1 -
Pediatric Dermatology Dec 1992
Review
Topics: Child; Dysplastic Nevus Syndrome; Humans; Nevus, Pigmented; Skin Neoplasms
PubMed: 1492049
DOI: 10.1111/j.1525-1470.1992.tb00621.x -
The American Journal of Surgical... Nov 2018PRAME (PReferentially expressed Antigen in MElanoma) is a melanoma-associated antigen that was isolated by autologous T cells in a melanoma patient. While frequent PRAME... (Comparative Study)
Comparative Study
PRAME (PReferentially expressed Antigen in MElanoma) is a melanoma-associated antigen that was isolated by autologous T cells in a melanoma patient. While frequent PRAME mRNA expression is well documented in cutaneous and ocular melanomas, little is known about PRAME protein expression in melanocytic tumors. In this study we examined the immunohistochemical expression of PRAME in 400 melanocytic tumors, including 155 primary and 100 metastatic melanomas, and 145 melanocytic nevi. Diffuse nuclear immunoreactivity for PRAME was found in 87% of metastatic and 83.2% of primary melanomas. Among melanoma subtypes, PRAME was diffusely expressed in 94.4% of acral melanomas, 92.5% of superficial spreading melanomas, 90% of nodular melanomas, 88.6% of lentigo maligna melanomas, and 35% of desmoplastic melanomas. When in situ and nondesmoplastic invasive melanoma components were present, PRAME expression was seen in both. Of the 140 cutaneous melanocytic nevi, 86.4% were completely negative for PRAME. Immunoreactivity for PRAME was seen, albeit usually only in a minor subpopulation of lesional melanocytes, in 13.6% of cutaneous nevi, including dysplastic nevi, common acquired nevi, traumatized/recurrent nevi, and Spitz nevi. Rare isolated junctional melanocytes with immunoreactivity for PRAME were also seen in solar lentigines and benign nonlesional skin. Our results suggest that immunohistochemical analysis for PRAME expression may be useful for diagnostic purposes to support a suspected diagnosis of melanoma. It may also be valuable for margin assessment of a known PRAME-positive melanoma, but its expression in nevi, solar lentigines, and benign nonlesional skin can represent a pitfall and merits further investigations to better assess the potential clinical utility of this marker.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Biomarkers, Tumor; Child; Female; Humans; Hutchinson's Melanotic Freckle; Immunohistochemistry; Male; Melanocytes; Melanoma; Middle Aged; Nevus, Pigmented; Reproducibility of Results; Skin Neoplasms; Young Adult
PubMed: 30045064
DOI: 10.1097/PAS.0000000000001134 -
The American Journal of Dermatopathology Dec 2004A unique combined mastocytoma-junctional nevus presented as a 4-mm dark brown macule in the axilla of a 57-year-old white female. Histopathologic examination revealed a...
A unique combined mastocytoma-junctional nevus presented as a 4-mm dark brown macule in the axilla of a 57-year-old white female. Histopathologic examination revealed a proliferation of mast cells partially or completely filling the dermal papillae, hyperpigmentation of the basal keratinocytes and mildly increased basal melanocytes. Overlying the mast cell proliferation, pigmented junctional nevus nests were present. The mast cells were strongly positive with Giemsa stain and mast cell tryptase immunohistochemical stain; nevomelanocytic cells were negative. Nevomelanocytes were strongly immunoreactive for S100, HMB-45, Mart-1, and tyrosinase; mast cells were negative. The clinicopathologic features suggested a synchronous proliferation of 2 cell types in the same small cutaneous field rather than a collision tumor. While the cutaneous mast cells probably originated as a disseminated clone, it is postulated that local mast cell growth factor induced nevomelanocytic proliferation and modulated mast cell growth. In fact, the tumor exhibited strong immunoreactivity for the mast cell growth factor receptor (CD117) in mast cells, basal melanocytes, and nevus nests. The incidence of dual mast cell-melanocytic tumors appears to be very low, as only 3 total cases have now been reported. However, since in patients with multiple mastocytomas only a small fraction of lesions are biopsied, the true incidence may be higher than supposed.
Topics: Diagnosis, Differential; Female; Humans; Immunohistochemistry; Mastocytoma; Middle Aged; Nevus, Pigmented; Skin Neoplasms
PubMed: 15618930
DOI: 10.1097/00000372-200412000-00007 -
International Journal of Clinical and... 2015Parotid malignancy may occur as a primary neoplasm of the salivary tissue or as metastatic involvement of the parotid lymph nodes. Primary tumors of squamous cell... (Review)
Review
Scalp junctional nevus with malignant transformation (melanoma) metastatic to parotid lymph node region, cervical lymph nodes and the back: a case report and review of literature.
Parotid malignancy may occur as a primary neoplasm of the salivary tissue or as metastatic involvement of the parotid lymph nodes. Primary tumors of squamous cell carcinoma and malignant melanoma involving the skin of the head and neck have the potential to spread to lymph nodes of the parotid gland. Metastatic malignant melanoma to the back was exceptionally rare and no such reports have been noted in the literature. We reported an exceptional case of intraparotid lymph nodes metastasis of the right scalp junctional nevus with malignant transformation to malignant melanoma in a 48-year-old man. The patient presented with a mass in the parotid gland area, which was misdiagnosed as a primary parotid tumor and surgical removal was performed. Unfortunately, recurrence with newly developed metastatic lesions in the back and cervical lymph nodes occurred 1 year after initial surgical management. This case is presented highlighting the unusual features of metastatic junctional nevus with malignant transformation to malignant melanoma of intraparotid lymph nodes, cervical lymph nodes and the back, which should help us to reduce misdiagnosis and obtain the best results.
Topics: Cell Transformation, Neoplastic; Head and Neck Neoplasms; Humans; Lymphatic Metastasis; Male; Melanoma; Middle Aged; Nevus, Pigmented; Parotid Neoplasms; Scalp; Skin Neoplasms
PubMed: 25755802
DOI: No ID Found -
Archives of Dermatology Jun 1978Speckled lentiginous nevus is, we feel, a distinctive nevocytic disorder and a clinical variety of nevus-cell nevus. The speckled areas show varying histological...
Speckled lentiginous nevus is, we feel, a distinctive nevocytic disorder and a clinical variety of nevus-cell nevus. The speckled areas show varying histological patterns that range from nevus incipiens to junctional and compound nevi. The background shows histological features of lentigo simplex. It is our contention that speckled lentiginous nevus should be separated from nevus spilus and nevus spilus tardus (Becker's), which we consider to be variants of epidermal nevus.
Topics: Adolescent; Adult; Child; Child, Preschool; Female; Humans; Infant; Infant, Newborn; Lentigo; Male; Nevus, Pigmented; Skin Neoplasms
PubMed: 666325
DOI: No ID Found -
Seminars in Diagnostic Pathology Aug 1998Ancient melanocytic nevus is an example of a simulator of malignant melanoma, designated ancient because it shares numerous features with ancient schwannoma. Knowledge... (Review)
Review
Ancient melanocytic nevus is an example of a simulator of malignant melanoma, designated ancient because it shares numerous features with ancient schwannoma. Knowledge of the histopathologic characteristics of this benign melanocytic neoplasm should enable pathologists to avoid overdiagnosis of it as melanoma arising in the intradermal portion of a nevus. Ancient nevi are found most commonly on the face of older persons. The neoplasm is usually a dome-shaped, skin-colored or reddish brown papule, usually with features of a Miescher's nevus. Histopathologically, ancient nevi are exoendophytic, mostly intradermal proliferations of two populations of melanocytes: one with large pleomorphic nuclei and the other with small monomorphous ones. The large melanocytes may resemble those of the epithelioid type of Spitz's nevus. A few mitotic figures may be present in a particular section. The epidermis usually is uninvolved, but sometimes there may be a junctional component. Other important findings are degenerative changes that include thrombi, zones of hemorrhage, pseudoangiomatous changes, thick rims of sclerosis around dilated venules, fibrosis, and mucin. Ancient nevi frequently are misdiagnosed as melanoma arising in an intradermal nevus.
Topics: Aged; Aged, 80 and over; Diagnosis, Differential; Diagnostic Errors; Face; Female; Follow-Up Studies; Humans; Male; Melanocytes; Melanoma; Middle Aged; Neoplasms, Second Primary; Nevus, Pigmented; Skin Neoplasms
PubMed: 9711671
DOI: No ID Found -
Oral Surgery, Oral Medicine, and Oral... Feb 1975Junctional nevi of the oral mucosa are rare and may be precancerous. A patient who had an enlarging junctional nevus of the labial mucosa with an adjacent lentigo...
Junctional nevi of the oral mucosa are rare and may be precancerous. A patient who had an enlarging junctional nevus of the labial mucosa with an adjacent lentigo simplex was studied by light and electron microscopy. On the basis of morphologic similarities--dentritic appearance, lack of desmonsomes, proliferative melanin production, and lack of cytoplasmic fibrils--it appears that the nevus cell most likely develops from melanocytes. The reason for the transformation from melanocyte to nevus cell or junctional nevus cell hyperplasia is unknown.
Topics: Acid Phosphatase; Aged; Basement Membrane; Biopsy; Cytoplasm; Female; Humans; Lip Neoplasms; Lysosomes; Macrophages; Melanins; Melanocytes; Mitochondria; Monophenol Monooxygenase; Mouth Mucosa; Nevus, Pigmented; Ribosomes; Vacuoles
PubMed: 804149
DOI: 10.1016/0030-4220(75)90227-3 -
Anais Brasileiros de Dermatologia 2017Recurrent melanocytic nevus is a proliferation of melanocytes arising from a melanocytic nevus removed partially. Asymmetry and irregular pigmentation may lead to...
Recurrent melanocytic nevus is a proliferation of melanocytes arising from a melanocytic nevus removed partially. Asymmetry and irregular pigmentation may lead to misdiagnosis of melanoma. We report a patient presented with a lesion on the lower abdomen, which was removed by shave excision. Anatomopathological examination revealed an intradermal melanocytic nevus. Two months later, a new irregular hyperpigmented lesion appeared in the surgical scar. Histopathology of the excisional biopsy revealed a recurrent melanocytic nevus. Recurrent melanocytic nevus manifests as a scar with hyper or hypopigmented areas, linear streaking, stippled pigmented halos, and/or diffuse pigmentation patterns. Histologically, the dermoepidermal junction and the superficial dermis show melanocytic proliferation overlying the scarred area. When a pathological report of the previous lesion is not available, complete excision is the gold standard. Otherwise, regular dermoscopic monitoring is a therapeutic option. The present report emphasizes the importance of histopathological examination of the excised material - even in cases of suspected benign lesions - and warns patients about the possibility of recurrence in case of incompletely removed lesions.
Topics: Biopsy; Cell Proliferation; Dermoscopy; Female; Humans; Melanocytes; Middle Aged; Neoplasm Recurrence, Local; Nevus, Pigmented; Skin Neoplasms
PubMed: 28954104
DOI: 10.1590/abd1806-4841.20176190 -
The American Journal of Dermatopathology Apr 1991This report describes an example of combined nevus with malignant transformation. The clinical impression was blue nevus. Histologically, the lesion was composed of a...
This report describes an example of combined nevus with malignant transformation. The clinical impression was blue nevus. Histologically, the lesion was composed of a cellular blue nevus in the reticular dermis and an overlying compound melanocytic nevus. The junctional component of the melanocytic nevus showed transition to malignant melanoma in situ. A review of the literature failed to find a precedent for the present case.
Topics: Cell Nucleus; Cytoplasm; Female; Humans; Melanocytes; Melanoma; Middle Aged; Neoplasms, Multiple Primary; Nevus, Pigmented; Skin Neoplasms
PubMed: 2029090
DOI: 10.1097/00000372-199104000-00011