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Bianchi A, Baldi A, Farabini A, Nibid L, Roberti V, Pellacani G, Kazakov DV, Donati M. Dermatoscopic, Histological and Confocal Microscopic Analysis of a Kissing Nevus of the Penis. Dermatopathology (Basel) 2023; 10:147-152. [PMID: 37366797 DOI: 10.3390/dermatopathology10020022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2023] [Revised: 05/24/2023] [Accepted: 05/26/2023] [Indexed: 06/28/2023] Open
Abstract
Kissing nevus is a congenital melanocytic neoplasm arising in those parts of the body that split at some point during embryological development (i.e., eyelid; penis), resulting in two adjacent melanocytic nevi. To date, 23 cases of kissing nevus of the penis have been described, and dermatoscopic and histological findings are available in 4/23 cases. We report a dermatoscopic, histological and confocal microscopic analysis in a new case of the kissing nevus of the penis in a 57 years old man. Dermatoscopic analysis showed large globules in the central area and a peripheral pigment network; the histological examination confirmed the presence of an intradermal melanocytic nevus with minimal junctional component and congenital features. Moreover, we reported, for the first time, confocal microscopy findings in the kissing nevus of the penis, revealing the presence of dendritic cells in correspondence with the epidermis and suggesting a state of cellular activity. Considering the clinicopathological features of the lesion, a conservative approach was adopted, and a clinical follow-up was planned after six months.
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Affiliation(s)
- Alexander Bianchi
- Fondazione Policlinico Tor Vergata, Tor Vergata University, 81-00133 Rome, Italy
| | - Alfonso Baldi
- Department of Environmental, Biological and Pharmaceutical Sciences and Technologies, University of Campania "L. Vanvitelli", 43-81100 Caserta, Italy
| | - Andrea Farabini
- Istituto di Medicina e Scienza dello Sport "Antonio Venerando", 1-00197 Rome, Italy
| | - Lorenzo Nibid
- Anatomical Pathology Unit, Department of Medicine and Surgery, Università Campus Bio-Medico di Roma, Via Alvaro del Portillo, 200-00128 Rome, Italy
| | - Vincenzo Roberti
- Dermatology Clinic, Sapienza University of Rome, 155-00161 Rome, Italy
| | | | - Dmitry V Kazakov
- IDP Institut für Dermatohistopathologie, Pathologie Institut Enge, Hardturmstrasse, 133-8005 Zurich, Switzerland
| | - Michele Donati
- Anatomical Pathology Unit, Fondazione Policlinico Universitario Campus Bio-Medico, Via Alvaro del Portillo, 200-00128 Rome, Italy
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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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Müller CSL, Müller SG, Vogt T, Pföhler C. Current concepts of ectopic nodal inclusions with special emphasis on nodal nevi. J Dtsch Dermatol Ges 2021; 19:1145-1157. [PMID: 34390159 DOI: 10.1111/ddg.14521] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/18/2021] [Indexed: 11/29/2022]
Abstract
Nodal inclusions of ectopic tissue within lymph nodes are seen comparatively often in dermatopathology and general pathology. Glandular and nonglandular epithelium, as well as melanocytic nevi can be observed within lymph nodes and represent mostly incidental findings without any relevance. The main challenge in reporting these morphologic features is to differentiate such benign inclusions from metastatic settlements of distinct organ tumors. As sentinel node biopsy and lymph node dissection have become standard procedure in clinical oncology and have an immense clinical impact, the correct evaluation of these nodal inclusions is indispensable to avoid undertreatment or overtreatment of patients. In addition, the genesis of these inclusions has not yet been satisfactorily clarified. Two concepts have been laid out: the theory of benign metastases and the migration arrest theory. However, neither theory has so far been able to answer the following questions: Why do we find more nodal nevi in patients with melanoma who had a sentinel node biopsy than in patients without melanoma, and why do we not find nodal nevi in deep visceral lymph nodes? We present a comprehensive review of the current knowledge on nodal inclusions, proposing a concept for the pathogenesis of nodal nevi, to answer these questions.
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Affiliation(s)
- Cornelia Sigrid Lissi Müller
- Medical supply center for Histology, Cytology, and Molecular diagnostics Trier GmbH, Wissenschaftspark Trier, TRIER, Germany
| | - Stephan G Müller
- Department of General-, Visceral-, Vascular- and Pediatric Surgery, Saarland University Medical Center, Homburg/Saar, Germany
| | - Thomas Vogt
- Department of Dermatology, Allergology, and Venerology, Saarland University Medical Center, Homburg/Saar, Germany
| | - Claudia Pföhler
- Department of Dermatology, Allergology, and Venerology, Saarland University Medical Center, Homburg/Saar, Germany
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Müller CSL, Müller SG, Vogt T, Pföhler C. Aktuelle Konzepte zu ektopen Lymphknoten‐Einschlüssen unter besonderer Berücksichtigung nodaler Nävi. J Dtsch Dermatol Ges 2021; 19:1145-1158. [PMID: 34390137 DOI: 10.1111/ddg.14521_g] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 03/18/2021] [Indexed: 11/28/2022]
Affiliation(s)
| | - Stephan G Müller
- Klinik für allgemeine Chirurgie, Viszeral-, Gefäß- und Kinderchirurgie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Thomas Vogt
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar
| | - Claudia Pföhler
- Klinik für Dermatologie, Allergologie und Venerologie, Universitätsklinikum des Saarlandes, Homburg/Saar
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Crawford M, Leclerc V, Barr K, Dagnino L. Essential Role for Integrin-Linked Kinase in Melanoblast Colonization of the Skin. J Invest Dermatol 2019; 140:425-434.e10. [PMID: 31330146 DOI: 10.1016/j.jid.2019.07.681] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Revised: 06/21/2019] [Accepted: 07/02/2019] [Indexed: 01/16/2023]
Abstract
Melanocytes are pigment-producing cells found in the skin and other tissues. Alterations in the melanocyte lineage give rise to a plethora of human diseases, from neurocristopathies and pigmentation disorders to melanoma. During embryogenesis, neural crest cell subsets give rise to two waves of melanoblasts, which migrate dorsolaterally, hone to the skin, and differentiate into melanocytes. However, the mechanisms that govern colonization of the skin by the first wave of melanoblasts are poorly understood. Here we report that targeted inactivation of the integrin-linked kinase gene in first wave melanoblasts causes defects in the ability of these cells to form long pseudopods, to migrate, and to proliferate in vivo. As a result, integrin-linked kinase-deficient melanoblasts fail to populate normally the developing epidermis and hair follicles. We also show that defects in motility and dendricity occur upon integrin-linked kinase gene inactivation in mature melanocytes, causing abnormalities in cell responses to the extracellular matrix substrates collagen I and laminin 332. Significantly, the ability to form long protrusions in mutant cells in response to collagen is restored in the presence of constitutively active Rac1, suggesting that an integrin-linked kinase-Rac1 nexus is likely implicated in melanocytic cell establishment, dendricity, and functions in the skin.
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Affiliation(s)
- Melissa Crawford
- Department of Physiology and Pharmacology, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Valerie Leclerc
- Department of Physiology and Pharmacology, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Kevin Barr
- Department of Physiology and Pharmacology, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada
| | - Lina Dagnino
- Department of Physiology and Pharmacology, Children's Health Research Institute, Lawson Health Research Institute, London, Ontario, Canada; Department of Oncology, University of Western Ontario, London, Ontario, Canada.
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Sood N, Mukherjee M. Dermal Lymphatic Invasion: A Rare Feature in Benign Intradermal Nevus. Int J Appl Basic Med Res 2019; 8:253-255. [PMID: 30598914 PMCID: PMC6259301 DOI: 10.4103/ijabmr.ijabmr_397_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
The present case describes classical intradermal nevus with intralymphatic nevus cell emboli. A 13-year-old boy presented with black colored macule on the shin 1 cm in diameter which was gradually increasing in size. Histopathology of the lesion was typical of an intradermal melanocytic nevus. The most notable feature of this case, however, was an occasional aggregate of nevus cells within a lymphatic vessel of the upper dermis. The nevus cells within lymphatic lumen had morphological features of type A nevus cells. The cells were roundtocuboidal, exhibited abundant cytoplasm with welldefined cell borders and formed nests. These nevus cell aggregates were surrounded by flattened endothelial cells. Due to its rarity, a lymphatic nevus cell embolus creates diagnostic issues for pathologists. This observation must not be interpreted as evidence of malignancy but significant as a rare histological feature. In other words, the nevus cells might have been transported through the lymphatic vessels as a “benign metastasis.”
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Affiliation(s)
- Neelam Sood
- Department of Pathology, Deen Dayal Upadhyay Hospital, New Delhi, India
| | - Moushmi Mukherjee
- Department of Pathology, Deen Dayal Upadhyay Hospital, New Delhi, India
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