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Kamata M, Minamisaka T, Imura J, Saitoh K, Shimomura A, Noguchi A. A Case of Dedifferentiated Melanoma With Lymph Node Metastasis Where Molecular Biological Tests Were Useful for Diagnosis. Cureus 2022; 14:e21644. [PMID: 35233321 PMCID: PMC8881242 DOI: 10.7759/cureus.21644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2022] [Indexed: 11/05/2022] Open
Abstract
Malignant melanoma is known to have an altered phenotype and loss of differentiation markers for melanoma due to metastasis. Here, we report a case in which the expression of the immunohistochemical markers for melanoma was changed due to lymph node metastasis of primary cutaneous malignant melanoma. The patient, a male in his 60s, was diagnosed with malignant melanoma after undergoing excision of a skin mass. The additional excision specimen showed a small number of tumor cell clusters infiltrating the dermis. The biopsied lymph node showed completely different histological findings from those of the skin lesion and consisted of spindle-shaped tumor cells. An immunohistochemical study revealed no significant positive reactions in the lymph node tissue indicative of melanoma. The additional genetic study revealed BRAF V600e mutations in both the primary tumor and a lymph node. Together with the histological findings, the diagnosis was of metastasis of dedifferentiated melanoma to a lymph node. In summary, there is a risk of underestimation or misdiagnosis of melanoma as undifferentiated sarcoma or other tumors when melanoma metastasizes to lymph nodes and findings show a dedifferentiated or undifferentiated tumor. Therefore, as in this case, it is necessary to add a genetic study in order to make a comprehensive judgment.
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Sakaguchi S, Takakura H, Hayashi SI, Noguchi A, Tachino H, Shojaku H, Imura J. Melanotic oncocytic metaplasia of the nasopharynx: A case report discussing the pathogenesis of a lesion. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Tasdogan A, McFadden DG, Mishra P. Mitochondrial DNA Haplotypes as Genetic Modifiers of Cancer. Trends Cancer 2020; 6:1044-1058. [PMID: 32980320 DOI: 10.1016/j.trecan.2020.08.004] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 08/05/2020] [Accepted: 08/18/2020] [Indexed: 02/06/2023]
Abstract
Mitochondria play an essential role in cellular metabolism, generation of reactive oxygen species (ROS), and the initiation of apoptosis. These properties enable mitochondria to be crucial integrators in the pathways of tumorigenesis. An open question is to what extent variation in the mitochondrial genome (mtDNA) contributes to the biological heterogeneity observed in human tumors. In this review, we summarize our current understanding of the role of mtDNA genetics in relation to human cancers.
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Affiliation(s)
- Alpaslan Tasdogan
- Children's Research Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - David G McFadden
- Department of Internal Medicine, Department of Biochemistry, Simmons Comprehensive Cancer Center, Division of Endocrinology, Program in Molecular Medicine, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA
| | - Prashant Mishra
- Children's Research Institute, University of Texas Southwestern Medical Center, Dallas, TX 75390, USA; Department of Pediatrics, Green Center for Systems Biology, University of Texas Southwestern Medical Center, Dallas, TX, 75390, USA.
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Abstract
Oncocytic metaplasia represents a histopathologic feature that can be observed in normal tissue such as salivary and lacrimal glands but may also constitute a degenerative metaplastic process as a result of repeated oxidative damage during cellular aging. Although cutaneous oncocytic metaplasia has been considered rare, the finding was seen in over one-third of melanocytic nevi prospectively evaluated, in one study. This case series reports on a small series of oncocytic melanocytic tumors, with the aim of describing this phenomenon in varied contexts and also describing the use of a mitochondrial antigen immunostain, which has not been previously reported.
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De Luise M, Girolimetti G, Okere B, Porcelli AM, Kurelac I, Gasparre G. Molecular and metabolic features of oncocytomas: Seeking the blueprints of indolent cancers. BIOCHIMICA ET BIOPHYSICA ACTA-BIOENERGETICS 2017; 1858:591-601. [DOI: 10.1016/j.bbabio.2017.01.009] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Revised: 12/28/2016] [Accepted: 01/17/2017] [Indexed: 02/07/2023]
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Reddy SP, Chong K, Cassarino DS. A rare case of cutaneous oncocytic hidradenoma. J Cutan Pathol 2016; 44:289-291. [PMID: 28035705 DOI: 10.1111/cup.12883] [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: 11/17/2016] [Revised: 12/22/2016] [Accepted: 12/26/2016] [Indexed: 11/30/2022]
Abstract
Oncocytes are epithelial cells characterized by their abundant eosinophilic and finely granular cytoplasm. Their histologic appearance is due to excessive amounts of cytoplasmic mitochondria. Oncocytes generally occur in the setting of benign neoplasms. Oncocytomas, or tumors composed primarily of oncocytes, are typically found in the kidneys. Other common sites include the salivary, thyroid, and parathyroid glands. Oncocytic metaplasia has only been rarely reported in various cutaneous neoplasms. We report a case of an elderly male presenting with a 5 mm erythematous papule on his left scalp, who underwent a shave biopsy showing a nodular, dermal-based adnexal tumor with prominent ductal differentiation, composed of multiple small, well-formed lumina surrounded by enlarged and bland-appearing epithelioid cells. Cytokeratin 7 (CK7), epithelial membrane antigen (EMA) and monoclonal carcinoembryonic antigen (mCEA) immunohistochemical stains were positive, consistent with adnexal differentiation. Phosphotungstic acid-hematoxylin (PTAH) and Luxol fast blue (LFB) stains highlighted the cytoplasmic granules, consistent with mitochondria. The overall findings were consistent with an oncocytic nodular hidradenoma. Oncocytic hidradenoma is a very rare entity, with only 1 previously reported case in the literature.
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Affiliation(s)
- Shivani P Reddy
- School of Medicine, University of Illinois at Chicago College of Medicine, Chicago, Illinois
| | - Kim Chong
- Departments of Dermatology and Pathology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
| | - David S Cassarino
- Departments of Dermatology and Pathology, Kaiser Permanente Los Angeles Medical Center, Los Angeles, California
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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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Gasparre G, Romeo G, Rugolo M, Porcelli AM. Learning from oncocytic tumors: Why choose inefficient mitochondria? BIOCHIMICA ET BIOPHYSICA ACTA-BIOENERGETICS 2011; 1807:633-42. [DOI: 10.1016/j.bbabio.2010.08.006] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/26/2010] [Revised: 08/09/2010] [Accepted: 08/15/2010] [Indexed: 10/19/2022]
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Guaraldi F, Zang G, Dackiw AP, Caturegli P. Oncocytic mania: a review of oncocytic lesions throughout the body. J Endocrinol Invest 2011; 34:383-94. [PMID: 21301204 DOI: 10.1007/bf03347464] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Oncocytic lesions are characterized pathologically by an abundance of oncocytes, that is by enlarged, eosinophilic, and finely granular cells enriched in mitochondria. They can arise in numerous organs and tissues, often in endocrine glands, and have been associated with hyperplasia, autoimmunity, and neoplasia. The causes and mechanisms that transform a normal cell into an oncocyte remain to be elucidated. Aim of this article is to review the most common oncocytic lesions, highlighting their key pathological features and clinical significance.
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Affiliation(s)
- F Guaraldi
- Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Kacerovska D, Sokol L, Michal M, Kazakov DV. Primary cutaneous signet-ring cell melanoma with pseudoglandular features, spindle cells and oncocytoid changes. Am J Dermatopathol 2009; 31:81-3. [PMID: 19155732 DOI: 10.1097/dad.0b013e3181814c5e] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
The authors report a 69-year-old man with a primary nodular malignant melanoma on the shoulder showing unusual histological features. It mostly consisted of markedly neoplastic melanocytes, which exhibited abundant clear cytoplasm compressing the nuclei to the periphery, resulting in a signet-ring appearance. In other areas of the melanoma, there were focally desmoplastic and pseudoglandular patterns and oncocytoid changes. Immunohistochemical studies showed that the tumor cells were uniformly positive only for S-100 protein and vimentin. Signet-ring cell melanoma is a rare histopathological variant of malignant melanoma with only a few described cases. To the best of our knowledge, this is the first case reporting a combination of the signet-ring cell melanoma with desmoplastic, pseudoglandular, and oncocytoid features.
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Affiliation(s)
- Denisa Kacerovska
- Sikl's Department of Pathology, Medical Faculty Hospital, Charles University, Bioptical Laboratory, Pilsen, Czech Republic
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Vancura RW, Thomas JH, Jewell WR, Damjanov I. Bilateral oncocytic malignant melanoma in axillary lymph nodes without evidence of an extranodal primary. Ultrastruct Pathol 2005; 29:399-404. [PMID: 16257866 DOI: 10.1080/019131290968731] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
A malignant melanoma was diagnosed in an axillary lymph node of a 49-year-old man. The tumor was examined by electron microscopy and was found to be composed of large oncocytic cells, filled with abundant mitochondria. No primary tumor could be identified on the skin or within internal organs. Approximately 2 years after the initial diagnosis, the patient presented with malignant melanoma in an axillary lymph node on the contralateral side. The second tumor also expressed the same oncocytic phenotype, favoring the common origin of both tumors. These data illustrate that oncocytic melanomas may retain their oncocytic phenotype during metastatic dissemination.
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Affiliation(s)
- Ryan W Vancura
- Department of Pathology & Laboratory Medicine, University of Kansas Hospital, School of Medicine, Kansas City, Kansas, USA
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Ide F, Obara K, Enatsu K, Mishima K, Saito I. Balloon cell nevus of the soft palate: an immunohistochemical and ultrastructural study. Pathol Int 2005; 54:872-6. [PMID: 15533232 DOI: 10.1111/j.1440-1827.2004.01760.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
An ultrastructural analysis of oral balloon cell nevus of intramucosal type complemented with an immunohistochemical study was performed for the first time. The lesion was composed of large balloon cells with an admixture of small nevus cells and melanophages at the periphery. Balloon cells showed cytoplasmic accumulation of vacuoles of varying sizes and the presence of microgranular and vacuolated melanosomes were found. Residual cytoplasm contained no identifiable organelles. A spectrum of transitional forms between balloon cells and conventional nevus cells with microvacuoles was readily observed. Both cells exhibited intense immunoreactivity to multiple melanocytic markers. Ballooning phenomenon was not evident in melanophages containing a large amount of melanosome complex. It can be inferred, from the present and previous observations, that progressive vacuolization of melanosomes in nevomelanocytes may be responsible for the formation of peculiar ballooning appearance, suggesting an aberrant melanogenesis.
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Affiliation(s)
- Fumio Ide
- Department of Pathology, Tsurumi University School of Dental Medicine, 2-1-3 Tsurmi, Tsurumi-ku, Yokohama, Japan.
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Abstract
BACKGROUND Oncocytosis is a cellular feature characterized by the presence of a finely granular eosinophilic cytoplasm due to the accumulation of mitochondria. While this histologic trait can be found in normal tissues, it is also seen pathologically as a degenerative phenomenon. We recently reviewed a spectrum of oncocytic melanocytic nevi that did not have clinical significance. We now describe similar changes in melanoma. METHODS We retrospectively reviewed 12 melanomas noted to have prominent granular eosinophilic cytoplasm and completed ultrastructural studies. We obtained patient histories and clinical follow-up information from the patients' physicians. RESULTS All cases were primary melanomas and showed prominent oncocytosis in the majority of the lesional melanoma cells. Oncocytosis was observed in both melanoma in situ and invasive melanoma with a wide range of Breslow thicknesses (range, 0.45-5.05 mm). It occurred in the presence and absence of ulceration, regression, vascular invasion, and brisk tumor infiltrating lymphocytes. Ultrastructural studies revealed melanocytes with numerous distorted mitochondria. CONCLUSION Melanoma is capable of presenting in a variety of histologic guises, including oncocytic change. While our observations are preliminary, this pathologic curiosity likely represents a degenerative phenomenon of little prognostic importance.
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Affiliation(s)
- Debra M Jih
- Department of Dermatology, MetroHealth Medical Center, Case Western Reserve University, 2500 MetroHealth Dr, Cleveland, OH 44109-1998, USA
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El-Gamal HM, Robinson-Bostom L, Saddler KD, Pan T, Mihm MC. Compound melanocytic nevi with granular cell changes. J Am Acad Dermatol 2004; 50:765-6. [PMID: 15097962 DOI: 10.1016/j.jaad.2003.11.068] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Two cases of compound melanocytic nevi with granular cell changes were studied. Histological examination revealed compound melanocytic nevi with a portion of the dermal component exhibiting a sheet like proliferation of nevoid cells with granular cytoplasm. Immunohistochemically, both populations of cells stained positive for S-100 and Melan-A. However, HMB-45 was positive only for the nevus cells with granular cytoplasm. We believe this represents granular cytoplasmic changes of nevus cells and does not denote malignant transformation.
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Affiliation(s)
- Hatem M El-Gamal
- Department of Dermatology Indiana University, School of Medicine, Indianapolis, Indiana, USA
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