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Kletskaya I, Belousova I, Makarova O, Narbutov A, Oganesyan R, Donati M, Říčař J, Salgado CM, Reyes-Múgica M, Kazakov DV. Schwannian and Perineuriomatous Differentiation in a Series of Giant Congenital Melanocytic Nevi. Am J Dermatopathol 2024; 46:483-491. [PMID: 38842402 DOI: 10.1097/dad.0000000000002754] [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: 06/07/2024]
Abstract
ABSTRACT Close relationship between melanocytes and neural cells is accepted to reflect their common derivation from the neural crest and tumors combining both elements. We present a series of 10 patients with giant congenital melanocytic nevi (CMN) in which a secondary proliferation (11 lesions) with schwannian and/or perineuriomatous differentiation developed in the course of the disease. The age of the patients (4 male and 6 female) at the time of surgery and histological assessment varied from 3 months to 57 years. Histopathologically, the following subgroups were delineated: (1) nodular/tumoriform "neurotization" in CMN, (2) diffuse neurofibroma-like proliferation within CMN, (3) plexiform neurofibroma-like proliferation within CMN, and (4) diffuse perineuriomatous (hybrid schwannomatous-perineuriomatous) differentiation in CMN. We review the pertinent literature, including the role of recently identified Schwann cell precursors which are believed to represent the nerve-associated state of neural crest-like cells that persists into later developmental stages.
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Affiliation(s)
- Irina Kletskaya
- Russian Children's Clinical Hospital of Pirogov's Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
- Dmitry Rogachev's National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Irena Belousova
- Department of Dermatology, Medical Military Academy, Saint Petersburg, Russia
| | - Olga Makarova
- Russian Children's Clinical Hospital of Pirogov's Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
| | - Anton Narbutov
- Russian Children's Clinical Hospital of Pirogov's Russian National Research Medical University of the Ministry of Healthcare, Russian Federation, Moscow, Russia
| | - Raisa Oganesyan
- Dmitry Rogachev's National Medical Research Center of Pediatric Hematology, Oncology and Immunology, Moscow, Russia
| | - Michele Donati
- Department of Pathology, University Hospital Campus Bio-Medico, Rome, Italy
| | - Jan Říčař
- Department of Dermatology, Charles University Medical Faculty Hospital, Pilsen, Czech Republic
| | - Claudia M Salgado
- Division of Pathology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh; and
| | - Miguel Reyes-Múgica
- Division of Pathology, UPMC Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pittsburgh; and
| | - Dmitry V Kazakov
- IDP Institut für Dermatohistopathologie, Pathologie Institut Enge, Zürich, Switzerland
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2
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Boroojerdi S, Weidemann S, Menz A, Lennartz M, Dwertmann Rico S, Schlichter R, Kind S, Reiswich V, Viehweger F, Bawahab AA, Höflmeyer D, Fraune C, Gorbokon N, Luebke AM, Hube-Magg C, Büscheck F, Krech T, Hinsch A, Jacobsen F, Burandt E, Sauter G, Simon R, Kluth M, Steurer S, Minner S, Marx AH, Bernreuther C, Clauditz TS, Dum D, Lebok P. Staining pattern of specific and cross-reacting Melan-A antibodies: A comparative study on 15,840 samples from 133 human tumor types. APMIS 2024; 132:479-491. [PMID: 38757248 DOI: 10.1111/apm.13408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 03/12/2024] [Indexed: 05/18/2024]
Abstract
The Melan-A (melanocyte antigen) protein, also termed 'melanoma antigen recognized by T cells 1' (MART-1) is a protein with unknown function whose expression is specific for the melanocyte lineage. Antibodies against Melan-A are thus used for identifying melanocytic tumors, but some Melan-A antibodies show an additional - diagnostically useful - cross-reactivity against an unspecified protein involved in corticosteroid hormone synthesis. To comprehensively compare the staining patterns of a specific and a cross-reactive Melan-A antibody in normal and neoplastic tissues, tissue microarrays containing 15,840 samples from 133 different tumor types and subtypes as well as 608 samples of 76 different normal tissue types were analyzed by immunohistochemistry. For the Melan-A-specific antibody 'Melan-A specific' (MSVA-900M), Melan-A positivity was seen in 96.0% of 25 benign nevi, 93.0% of 40 primary and 86.7% of 75 metastatic melanomas, 82.4% of 85 renal angiomyolipomas as well as 96.4% of 84 neurofibromas, 2.2% of 46 granular cell tumors, 1.0% of 104 schwannomas, and 1.1% of 87 leiomyosarcomas. The cross-reactive antibody 'Melan-A+' (MSVA-901M+) stained 98.1% of the tumors stained by 'Melan-A specific'. In addition, high positivity rates were seen in sex-cord-stroma tumors of the ovary (35.3%-100%) and the testis (86.7%) as well as for adrenocortical neoplasms (76.3%-83.0%). Only nine further tumor groups showed Melan-A+ staining, including five different categories of urothelial carcinomas. Our data provide a comprehensive overview on the staining patterns of specific and cross-reactive Melan-A antibodies. The data demonstrate that both antibodies are highly useful for their specific purpose. It is important for pathologists to distinguish these two Melan-A antibody subtypes for their daily work.
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Affiliation(s)
- Shiva Boroojerdi
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | - Ria Schlichter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Simon Kind
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Viktor Reiswich
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Florian Viehweger
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ahmed Abdulwahab Bawahab
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Pathology, Faculty of Medicine, University of Jeddah, Jeddah, Saudi Arabia
| | - Doris Höflmeyer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Franziska Büscheck
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Andrea Hinsch
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Andreas H Marx
- Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
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Takada T. Relationship between dermoscopic and histopathological findings of extradigital glomus tumors. Clin Case Rep 2024; 12:e8907. [PMID: 38770410 PMCID: PMC11103558 DOI: 10.1002/ccr3.8907] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 04/08/2024] [Accepted: 05/01/2024] [Indexed: 05/22/2024] Open
Abstract
In extradigital glomus tumors, (1) noncontact and (2) contact dermoscopy show (1) a central purplish-white area corresponding to tumor nests surrounding enlarged vessels, a peripheral yellow-white area corresponding to mucin deposition, melanin granules, and fibrous tissue, and (2) white reticular and linear cord areas corresponding to pseudocapsules and collagen fibers.
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4
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Jaeger ZJ, Dehner C, Dehner LP. Rosette-like formations in melanocytic neoplasms: A case report and literature review. J Cutan Pathol 2022; 49:818-823. [PMID: 35679430 DOI: 10.1111/cup.14270] [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: 03/18/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 11/29/2022]
Abstract
Homer-Wright-like rosettes are a common finding in neural tumors but seldom seen in melanocytic nevi and melanoma. We report a case of a 23-year-old male with a compound melanocytic nevus with such rosette-like structures and summarize the current literature on this histopathological feature in melanocytic neoplasms. A symmetric, well-circumscribed, compound nevus consisting of aggregations of epithelioid melanocytes with eccentric nuclei and central eosinophilic cytoplasm, resembling Homer-Wright rosettes, was present on biopsy. Immunohistochemical stains strongly supported a melanocytic entity and were negative for NTRK1/2/3, a fusion protein potentially associated with rosette-like structures. We found 17 other cases of benign melanocytic nevi, including 9 atypical Spitz tumors and 6 Spitz nevi, and 11 malignant melanomas, including 3 Spitz melanomas and 4 metastases. We observed remarkable diversity among lesion morphologies containing rosettes, as well as level of prominence and cytology of the rosettes themselves. This case illustrates the morphologic malleability of neural-crest-derived lesions to share microscopic and phenotypic attributes.
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Affiliation(s)
- Zachary J Jaeger
- Office of Medical Student Education, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Carina Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology and Dermatopathology Center, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
| | - Louis P Dehner
- Lauren V. Ackerman Laboratory of Surgical Pathology and Dermatopathology Center, Department of Pathology and Immunology, Washington University School of Medicine, St. Louis, Missouri, USA
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5
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Brown RA, Wang JY, Raghavan SS, Zhang J, Wan DC, Born D, Koo M, Hazard FK, Novoa RA, Rieger KE. ALK-positive compound Spitz nevus with extensive perineural and intraneural neurotropism. J Cutan Pathol 2020; 48:154-159. [PMID: 33034114 DOI: 10.1111/cup.13890] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2020] [Revised: 10/01/2020] [Accepted: 10/04/2020] [Indexed: 01/18/2023]
Abstract
Historically recognized by their characteristic histopathologic features, Spitz neoplasms are now known to be molecularly defined by mutually exclusive recurrent abnormalities that cause activation of the MAPK pathway. Spitz neoplasms with ALK rearrangements frequently demonstrate polypoid growth with a plexiform arrangement of nested, fusiform melanocytes in intersecting fascicles. Although neurotropism has been described in indolent Spitz neoplasms, this feature is not frequently mentioned in publications on histopathologic assessment of this group of melanocytic tumors. Here, we present an unusual case of a 3-year-old female with an ALK-positive compound Spitz nevus with extensive perineural and intraneural neurotropism occurring on the vermilion border of the lower lip.
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Affiliation(s)
- Ryanne A Brown
- Department of Pathology, Stanford Medicine, Stanford, California, USA.,Department of Dermatology, Stanford Medicine, Stanford, California, USA.,Department of Pathology, Veterans Affairs Palo Alto Health Care System, Palo Alto, California, USA
| | - Jennifer Y Wang
- Department of Pathology, Stanford Medicine, Stanford, California, USA.,Department of Dermatology, Stanford Medicine, Stanford, California, USA
| | - Shyam S Raghavan
- Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia, USA
| | - Jingjing Zhang
- Department of Pathology, Stanford Medicine, Stanford, California, USA
| | - Derrick C Wan
- Department of Surgery, Division of Plastic and Reconstructive Surgery, Stanford Medicine, Stanford, California, USA
| | - Donald Born
- Department of Pathology, Stanford Medicine, Stanford, California, USA
| | - Matthew Koo
- Department of Pathology, Stanford Medicine, Stanford, California, USA
| | - Florette K Hazard
- Department of Pathology, Stanford Medicine, Stanford, California, USA
| | - Roberto A Novoa
- Department of Pathology, Stanford Medicine, Stanford, California, USA.,Department of Dermatology, Stanford Medicine, Stanford, California, USA
| | - Kerri E Rieger
- Department of Pathology, Stanford Medicine, Stanford, California, USA.,Department of Dermatology, Stanford Medicine, Stanford, California, USA
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6
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Malignant peripheral nerve sheath tumor in the cervical spine with multiple nevus cell nevi. J Orthop Sci 2016; 21:250-4. [PMID: 26740424 DOI: 10.1016/j.jos.2015.06.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2014] [Revised: 10/12/2014] [Accepted: 10/30/2014] [Indexed: 10/23/2022]
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7
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Fernandez-Flores A, Cassarino DS. Unusual Histopathological Patterns in Melanocytic Nevi With Some Previously Undescribed Patterns. Am J Dermatopathol 2016; 38:167-85. [PMID: 26894768 DOI: 10.1097/dad.0000000000000381] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Melanocytic nevi are one of the most common diagnoses in the daily practice of any dermatopathologist. Although in the vast majority of cases the final diagnosis is not difficult, there are certain rare and unusual morphologic variations that can elicit some diagnostic problems. Although some of these variations can be considered as mere morphologic oddities, others might lead to a differential diagnosis with melanoma, or with other tumors, including epithelial or neural tumors. In the current report, we review many of these morphologic variations and discuss the main differential diagnosis, when appropriate.
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Affiliation(s)
- Angel Fernandez-Flores
- *Consultant Histopathologist, Department of Cellular Pathology, Hospital El Bierzo, Ponferrada, Spain; and †Consultant Dermatopathologist, Department of Pathology, Southern California Kaiser Permanente, Los Angeles Medical Center (LAMC), Los Angeles, CA
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8
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Ferro de Beça F, Lopes J, Maçoas F, Carneiro F, Lopes JM. Tactoid body features in a Schwann cell hamartoma of colonic mucosa. Int J Surg Pathol 2013; 22:438-41. [PMID: 23994879 DOI: 10.1177/1066896913501384] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Mesenchymal colorectal polyps are uncommon lesions, particularly those of neurogenic origin. We describe a mucosal Schwann cell hamartoma of the colon with tactoid features, so far reported in peripheral nerve sheath tumours, and address its differential diagnosis and clinical implications. CASE PRESENTATION A 72-year-old man underwent screening colonoscopy that presented a 5-mm polyp on distal sigmoid. Histologically, it displayed a lesion in the lamina propria comprising oval structures with tactoid features and bland spindle cells, entrapping adjacent crypts. No ganglion cells were seen. Spindle cells expressed only S-100 protein and vimentin. DISCUSSION Mucosal Schwann cell hamartoma was recently recognized as distinct from common (submucosal) colorectal Schwannomas and so far not associated to inherited syndromes. Thus, it should be considered in the differential diagnosis of look-alike lesions (eg, ganglioneuroma, neuroma, and neurofibroma) that may occur in the setting of inherited syndromes such as Cowden syndrome, multiple endocrine neoplasia-2B, and type 1 neurofibromatosis.
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Affiliation(s)
- Francisco Ferro de Beça
- IPATIMUP, Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal Faculty of Medicine, University of Porto, Porto, Portugal Centro Hospitalar de São João, Porto, Portugal
| | | | | | - Fátima Carneiro
- IPATIMUP, Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal Faculty of Medicine, University of Porto, Porto, Portugal Centro Hospitalar de São João, Porto, Portugal
| | - José Manuel Lopes
- IPATIMUP, Institute of Molecular Pathology and Immunology of the University of Porto, Porto, Portugal Faculty of Medicine, University of Porto, Porto, Portugal Centro Hospitalar de São João, Porto, Portugal
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9
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Melanocytic Differentiation Is Present in a Significant Proportion of Nonpigmented Diffuse Neurofibromas. Am J Surg Pathol 2013; 37:1182-91. [DOI: 10.1097/pas.0b013e31828950a3] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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10
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Chen Y, Klonowski PW, Lind AC, Lu D. Differentiating Neurotized Melanocytic Nevi From Neurofibromas Using Melan-A (MART-1) Immunohistochemical Stain. Arch Pathol Lab Med 2012; 136:810-5. [DOI: 10.5858/arpa.2011-0335-oa] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Context.—Neurotized melanocytic nevi and neurofibromas are common, benign cutaneous neoplasms. Usually they are histologically distinct from each other; however, neurotized melanocytic nevi and neurofibromas can be clinically and histologically similar.
Objective.—To determine whether Melan-A (MART-1) immunohistochemical stain is sufficient to differentiate neurotized melanocytic nevi from neurofibromas.
Design.—Forty-nine consecutive specimens of melanocytic nevi with neurotization and 49 specimens of neurofibromas were selected. We used antibodies against Melan-A, S100, and neurofilament protein.
Results.—All of the melanocytic nevi showed Melan-A staining within the neurotized areas, with most of the areas staining strongly positive, whereas all the neurofibromas were completely absent of Melan-A stain. All of the nevi, including the neurotized areas, stained strongly and diffusely for S100, whereas all the neurofibromas showed a distinctive, sharp, wavy pattern of S100 staining. Neurofilament protein showed scattered staining of both melanocytic nevi and neurofibromas.
Conclusions.—Our data indicate that Melan-A immunohistochemical staining is helpful in differentiating neurotized melanocytic nevi from neurofibromas when distinction on histomorphology alone is difficult.
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11
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Cutaneous neoplasms with prominent Verocay body-like structures: the so-called "rippled pattern". Am J Dermatopathol 2011; 33:539-48; quiz 549-50. [PMID: 21778831 DOI: 10.1097/dad.0b013e31820562cd] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
A striking appearance resulting from alternating areas of epithelial cell cords and stroma seen in some cutaneous adnexal neoplasms has been referred to as the "rippled pattern." Histologically, this pattern may be indistinguishable from Verocay bodies described in schwannomas. A number of common and clinically diverse cutaneous neoplasms can be linked by the presence of this unusual growth pattern. The heterogeneous group of tumors that have been known to demonstrate this feature includes those with epithelial, adnexal, fibrohistiocytic, mesenchymal, and melanocytic lineage. The objective of this review is to alert the dermatopathologist to the range of neoplasms, which can potentially show this attribute, so that a misdiagnosis can be avoided.
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12
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Melanocytic schwannoma of the cutaneous and subcutaneous tissues: three cases and a review of the literature. Melanoma Res 2008; 18:438-42. [DOI: 10.1097/cmr.0b013e32831270d7] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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13
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Weinreb I, Labonte S, Goli H, Chetty R, Ghazarian D. Cutaneous melanocytoneuroma: the first case of a distinctive intraneural tumor with dual nerve sheath and melanocytic differentiation. J Cutan Pathol 2007; 34 Suppl 1:52-7. [DOI: 10.1111/j.1600-0560.2007.00733.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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14
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Hantschke M. [Hypopigmented melanocytic tumors with spindle cells. A review]. DER PATHOLOGE 2007; 28:403-10. [PMID: 17851662 DOI: 10.1007/s00292-007-0939-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Hypopigmented and achromatic melanocytic tumors with spindle cells represent a diagnostic challenge. Spindle cell nevi resemble neural tumors. Desmoplastic nevi imitate dermatofibromas. Hypopigmented and amelanotic blue nevi are variants of the common and cell-rich blue nevus with an enhanced difficulty to make a correct diagnosis due to the lack of pigment. All of the above benign melanocytic tumors with proliferations of hypopigmented spindle cells can more or less show aspects of desmoplastic melanoma. The differential diagnosis of these entities demands a combination of clinical and histological parameters as well as supporting immunostaining. Regarding desmoplastic melanoma, diagnoses frequently made are benign spindle cell neoplasms, scar or unspecific inflammatory condition. As the histological aspects can be so misleading, attention is necessary in order to make the correct diagnosis. Particular care must be taken to rule out desmoplastic melanoma in the case of spindle cell proliferations, a cicatricial or inflammatory process in the classical settings of face, volar skin, or mucous membranes. The spindle cell melanoma must be distinguished from other types of malignant spindle cell neoplasms, which can involve the skin. The differential diagnosis with such tumors is entrusted mainly to immunostaining.
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Affiliation(s)
- M Hantschke
- Dermatopathologische Gemeinschaftspraxis, Siemensstrasse 6/1, 88048, Friedrichshafen, Deutschland.
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15
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Ide F, Mishima K, Yamada H, Saito I, Tanaka A, Kusama K. Neurotized nevi of the oral mucosa: an immunohistochemical and ultrastructural analysis of nevic corpuscles. J Oral Pathol Med 2007; 36:505-10. [PMID: 17686011 DOI: 10.1111/j.1600-0714.2007.00566.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Nevic corpuscle (NC), a stacked lamellar structure reminiscent of Meissner corpuscle, is frequently observed in dermal melanocytic nevi. Although the heading 'neurotized' is classically used for these nevi, the exact neural nature of NC has been a topic of considerable debate. Neurotized nevi have received little attention in the dental literature, and there was no information on NC in oral melanocytic nevi. METHODS Six cases of oral intramucosal nevi with a significant number of NC (two completely and four partially neurotized nevi) were examined immunohistochemically and ultrastructurally. RESULTS NC was composed of closely piled laminar cells devoid of visible melanin. NC and associated spindle nevus cells were immunopositive for S-100 protein but negative for HMB-45, myelin basic protein and epithelial membrane antigen. Within NC, no reactivity for neurofilament protein, protein gene product 9.5 or peripherin was evident. Numerous CD34-positive dendritic cells were located between nevus cells and often encircled NC. Ultrastructurally, NC consisted of concentrically layered elongated cells with a slender lamellated cytoplasm rich in thin filaments and pinocytotic vesicles. Their cytoplasmic processes were focally covered by external basal lamina and continuous to spindle nevus cells. Occasional NC cells contained a few melanosomes. There was no interposed axon in NC. CONCLUSIONS Despite the close resemblance to Meissner corpuscle, NC showed no axonal supply. NC cells lacked terminal Schwannian differentiation and appeared to be modified melanocytes with some perineurial ultrastructural characteristics. The presence of CD34-positive cells, presumably corresponding to endoneurial fibroblasts, further supports an organizational relationship of NC and peripheral nerve sheath elements.
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Affiliation(s)
- F Ide
- Division of Pathology, Department of Diagnostic and Therapeutic Sciences, Meikai University School of Dentistry, Saitama, Japan.
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Kazakov DV, Michal M. Melanocytic “ball-in-mitts” and “microalveolar structures” and their role in the development of cellular blue nevi. Ann Diagn Pathol 2007; 11:160-75. [PMID: 17498590 DOI: 10.1016/j.anndiagpath.2007.03.001] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
To test the hypothesis of whether cellular blue nevi (CBN) may originate from "ordinary" compound and dermal nevi, a total of 275 melanocytic nevi including 59 CBN, 34 ordinary blue nevi, 87 combined nevi (including 43 so-called clonal nevi), 35 deep penetrating nevi, and 60 ordinary compound and dermal nevi (30 of each) were studied for the presence of so-called ball-in-mitts and microalveolar structures. A ball-in-mitts structure was defined as a single centrally placed melanocyte with a round to oval nucleus (the "ball" cell) and a clear, dusty, or pigmented cytoplasm encircled by a single dendritic cell (the "mitt" cell) with an oval to spindle-shaped nucleus and slender bipolar processes containing melanin and surrounding at least one fourth of the ball's diameter. A microalveolar structure was defined as a group of 2 to 10 centrally placed melanocytes with round to oval nuclei and clear, dusty, or pigmented cytoplasm (balls) surrounded by one or more cells (mitts) with spindle-shaped nuclei and slender bipolar processes containing melanin. Microscopically, ball-in-mitt and microalveolar structures were detected in all types of nevi studied, with the highest incidence in combined nevi (82%), CBN (76%), and ordinary "nonblue" nevi (73%). In CBN, ball-in-mitts and microalveolar structures tended to be located in the deeper portion of the lesions, whereas in ordinary nonblue nevi, they were most often found superficially, just below the epidermis; in clonal nevi, these structures were often confined to the "clonal" parts. Immunohistochemically, ball-in-mitts and microalveolar structures were positive for HMB45. Ultrastructurally, the balls tended to have round to oval nuclei, whereas the mitts possessed oval, elongated to spindled nuclei. Melanosomes were found in various stages in the cells of both structures. The cytoplasm of the mitts typically formed elongated polar processes, sometimes with club-like widenings at the ends, completely or partially encircling the balls. In the microalveolar structures, the adjacent cells forming the mitts surrounded the ball cells like a chain. Our study suggests that some or even most cases of CBN may evolve from ordinary nonblue nevi. This process may involve several steps and is probably reflected by the appearances of combined nevi, deep penetrating nevi, and CBN. These nevi often show a morphological overlap, and ball-in-mitts and microalveolar structures found in various stages of their development seem to greatly account for this overlap.
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MESH Headings
- Adolescent
- Adult
- Aged
- Aged, 80 and over
- Antigens, Neoplasm
- Cell Nucleus/pathology
- Cell Nucleus/ultrastructure
- Child
- Child, Preschool
- Disease Progression
- Female
- Gene Expression Regulation, Neoplastic
- Humans
- Male
- Melanocytes/pathology
- Melanoma-Specific Antigens
- Middle Aged
- Neoplasm Proteins/metabolism
- Nevus/pathology
- Nevus, Blue/etiology
- Nevus, Blue/metabolism
- Nevus, Blue/pathology
- Nevus, Pigmented/etiology
- Nevus, Pigmented/metabolism
- Nevus, Pigmented/pathology
- Skin Neoplasms/etiology
- Skin Neoplasms/metabolism
- Skin Neoplasms/pathology
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Affiliation(s)
- Dmitry V Kazakov
- Sikl's Department of Pathology, Charles University, Medical Faculty Hospital, 304 60 Pilsen, Czech Republic.
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17
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Salim S, Liu B, Mahmoodi M, Asad H, Hou SJ. Tactile-like corpuscles in gastric mucosa: a case report. World J Surg Oncol 2006; 4:39. [PMID: 16822307 PMCID: PMC1543630 DOI: 10.1186/1477-7819-4-39] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2005] [Accepted: 07/05/2006] [Indexed: 11/28/2022] Open
Abstract
Background The presence of tactile corpuscle-like structures in Schwannomas, Neurofibromas and Neuroid Intradermal Melanocytic Nevi is well-documented. We report a case describing the presence of such structures in the lamina propria of grossly normal gastric mucosa. Case presentation A 30 year-old male underwent esophagogastrectomy for carcinoma. Examination of hematoxylin and eosin stained sections reveal tactile corpuscle-like structures in the mucosa adjacent to the main tumor mass. Conclusion This is a rare phenomenon and a literature search revealed only one paper describing such structures in the benign colonic mucosa of a colectomy done for carcinoma. We did not come across any cases in the literature describing such structures in gastrointestinal specimen resected for reasons other than carcinoma. To our knowledge this would be the first case reporting the existence of tactile corpuscles-like structures in gastric mucosa.
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Affiliation(s)
- Sadia Salim
- Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Beiqing Liu
- Department of Pathology, St. Peter's Hospital, 315 South Manning Blvd, Albany, NY, USA
| | - Mandana Mahmoodi
- Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Haider Asad
- Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
| | - Steve J Hou
- Department of Pathology and Laboratory Medicine, Drexel University College of Medicine, Philadelphia, PA, USA
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18
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Ball NJ, Kho GT. Melanocytic nevi are associated with neurofibromas in neurofibromatosis, type I, but not sporadic neurofibromas: a study of 226 cases. J Cutan Pathol 2005; 32:523-32. [PMID: 16115049 DOI: 10.1111/j.0303-6987.2005.00376.x] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND Neurofibromatosis, type 1, is associated with cutaneous melanin pigmentation, but an association with ordinary melanocytic nevi has not been described. METHODS This retrospective case-control study was designed to see if neurofibromas in patients with neurofibromatosis, type 1 (NF-1) differ from sporadic neurofibromas (SN) in their incidence of associated melanocytic nevi and other histologic features. Slides from 114 NF-1 were compared with 112 SN and 300 intradermal melanocytic nevi (IDN). RESULTS Small lentiginous melanocytic nevi were identified over 13 NF-1 (11%) but no SN (P=0.0002). Compared with other NF-1, NF-1 with nevi were more frequently associated with melanocytic hyperplasia, giant melanosomes and diffuse neurofibroma (P<0.03). Compared with SN, NF-1 were also more frequently associated with melanocytic hyperplasia, lentigo simplex-like changes, diffuse neurofibroma and plexiform neurofibroma (P<0.001). Sebaceous hyperplasia (14%), dermal elastosis (9%), lipomatous change (8%), epithelial cysts (4%) and keratin granulomas or folliculitis (3%) were not significantly different in prevalence between NF-1, SN and the control group of IDN. CONCLUSIONS This study suggests that there is a difference in the potential for melanocytic proliferation in NF-1 compared with SN. NF-1, SN and IDN are associated with a similar range of incidental histologic changes. Ball NJ, Kho GT. Melanocytic nevi are associated with neurofibromas in neurofibromatosis, type 1, but not sporadic neurofibromas. A study of 226 cases.
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Affiliation(s)
- Nigel J Ball
- Department of Pathology, The University of British Columbia, Vancouver General Hospital, Vancouver, British Columbia, Canada.
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