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Mert M, Bozdogan O, Bozdogan N, Gamsızkan M, Safali M. PRAME and Historical Immunohistochemical Antibodies Ki-67, P16, and HMB-45 in Ambiguous Melanocytic Tumors. Am J Dermatopathol 2024:00000372-990000000-00374. [PMID: 38916203 DOI: 10.1097/dad.0000000000002768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024]
Abstract
ABSTRACT Ambiguous melanocytic lesions/tumors (AMLs) can be simply described as melanocytic neoplasms that cannot be differentiated as either a melanoma or a nevus. Preferentially expressed antigen in melanoma (PRAME) is a novel antibody that can help differentiate between nevi and melanomas. However, its usefulness remains controversial in AMLs. The aim of this study was to demonstrate the importance of PRAME and diagnostic auxiliary antibodies (Ki-67, p16, HMB-45) in the diagnosis of melanocytic lesions, especially in AMLs. This study included 52 ambiguous melanocytic lesions, 40 nevi, and 40 melanomas. All immunohistochemical studies were performed automatically using the Universal Alkaline Phosphatase Red Detection Kit. Different analytic approaches were used for each antibody based on the literature. Statistically, the multinomial forward stepwise elimination logistic regression analysis was used to create a statistical model to predict the diagnosis of melanocytic lesions based on clinical, morphological, and immunohistochemical data. PRAME positivity was very strong and diffuse in the melanoma group and statistically significantly higher than that of the AML and nevus groups. There was no statistically significant difference between the nevus and AML groups. The Ki-67 proliferation index and HMB-45 staining pattern provided valuable indications for distinguishing between these 3 groups. The P16 antibody was limited in supporting the differential diagnosis. Our statistical model showed that a high mitosis count, central pagetoid spread, and PRAME positivity increased the probability of melanoma against an AML diagnosis. This study showed the advantages of evaluating the PRAME antibody together with morphological features and other immunohistochemical markers (Ki-67 and HMB-45) in the differential diagnosis of melanocytic lesions.
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Affiliation(s)
- Merve Mert
- Medical Pathology Department, Afyonkarahisar Public Hospital, Afyonkarahisar, Turkey
| | - Onder Bozdogan
- Medical Pathology Department, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Nazan Bozdogan
- Medical Pathology Department, University of Health Sciences, Dr. Abdurrahman Yurtaslan Oncology Training and Research Hospital, Ankara, Turkey; and
| | - Mehmet Gamsızkan
- Medical Pathology Department, Duzce University School of Medicine, Duzce, Turkey
| | - Mukerrem Safali
- Medical Pathology Department, University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
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2
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Rasic D, Korsgaard N, Marcussen N, Precht Jensen EM. Diagnostic utility of combining PRAME and HMB-45 stains in primary melanocytic tumors. Ann Diagn Pathol 2023; 67:152211. [PMID: 37717457 DOI: 10.1016/j.anndiagpath.2023.152211] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 09/11/2023] [Accepted: 09/12/2023] [Indexed: 09/19/2023]
Abstract
BACKGROUND Pathologists face ongoing challenges distinguishing between benign and malignant melanocytic tumors. PRAME (PReferentially expressed Antigen in Melanoma) has a demonstrated value distinguishing between these types of lesions. However, the sensitivity of single immunohistochemistry is variable. HMB-45 is another valuable marker, but on its own, has a limited ability in setting of primary melanocytic tumors. This study sought to evaluate the diagnostic potential of a dual panel combining PRAME and HMB-45 in the assessment of primary melanocytic tumors. METHODS 259 tumors, of which 141 were benign nevi, 31 dysplastic nevi (either low- or high grade dysplasia), and further 87 malignant melanomas, were retrieved from the department's archives and assessed by two experienced dermatopathologists. New sections were stained with PRAME and HMB-45, respectively. For PRAME, a nuclear, and for HMB-45, a cytoplasmic staining, was considered positive and scored as described in the literature on a scale from 0 to 4+. Only dermal component was assessed on HMB-45 stain. RESULTS PRAME was diffusely expressed in only 1 benign nevus, with focal expression in further 28 compared to 22 diffusely and 103 focally HMB-45-positive benign nevi. 5 high-grade dysplastic nevi showed diffuse PRAME expression in epidermal component, with varying degree of positivity in adjacent dermal compartment, and further 8 dysplastic nevi showed only focal expression. HMB-45 was diffusely expressed in only 2, with focal expression in 23, and no apparent positivity in remaining 6 dysplastic nevi. In invasive melanoma group, PRAME stained >75 % cells in 64/87 tumors, however, 10/87 melanomas were completely negative. HMB-45 was captured diffusely in 49/87 melanomas, 32 showed patchy expression, and 6 tumors were blank negative. Diffuse 4+ PRAME positivity showed superior sensitivity and specificity of 73,6 % and 96,5 %, respectively, compared to HMB-45, 56,3 % and 86,0 %, respectively. No nevi showed double 4+ positivity, however, the sensitivity for double positivity was only 49,4 %. CONCLUSION Our results confirm the superiority of PRAME over HMB-45 in the differential diagnosis of melanocytic tumors. However, combined staining can significantly increase specificity, rendering a benign diagnosis more unlikely in a double 4+ diffuse positivity setting.
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Affiliation(s)
- Dusan Rasic
- Department of Pathology, Research Unit of Pathology, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark.
| | - Niels Korsgaard
- Department of Clinical Pathology, Hospital South West Jutland, 6700 Esbjerg, Denmark.
| | - Niels Marcussen
- Department of Pathology, Research Unit of Pathology, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark.
| | - Eva Magrethe Precht Jensen
- Department of Pathology, Research Unit of Pathology, University Hospital of Southern Denmark, 6200 Aabenraa, Denmark.
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Ludzik J, Foltz EA, Gillespie J, Witkowski A. Sequential Dermoscopy and Reflectance Confocal Microscopy Paired With Pigmented Lesion Assay Gene Expression Profiling for In Vivo Monitoring of Multiple Halo Nevi on an Adult Patient. Cureus 2023; 15:e49465. [PMID: 38152824 PMCID: PMC10751467 DOI: 10.7759/cureus.49465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/26/2023] [Indexed: 12/29/2023] Open
Abstract
The halo nevus is characterized by a ring of depigmentation appearing around an acquired or congenital melanocytic nevus. When observed in children, halo nevi are generally not a cause of concern. However, adult-onset halo nevi have an associated risk of primary cutaneous melanoma that corresponds to the risk of melanoma in patients with atypical nevi or a personal/familial history of melanoma. Thus, new-onset halo nevi in adults requires close follow-up and monitoring for malignancy. Herein we present a case of an adult patient who received sequential digital dermoscopy, reflectance confocal microscopy, and pigmented lesion assay gene expression profiling to monitor two halo nevi over a three-month period.
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Affiliation(s)
- Joanna Ludzik
- Dermatology, Oregon Health & Science University, Portland, USA
| | - Emilie A Foltz
- Dermatology, Washington State University Elson S. Floyd College of Medicine, Spokane, USA
- Dermatology, Oregon Health & Science University, Portland, USA
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Abstract
ABSTRACT Preferentially expressed antigen in melanoma (PRAME) is a tumor-associated antigen first identified in a melanoma patient and found to be expressed in most melanomas as well as in variable levels in other malignant neoplasms of epithelial, mesenchymal, or hematolymphoid lineage. Detection of PRAME expression in formalin-fixed paraffin-embedded tissue is possible by immunohistochemistry (IHC) with commercially available monoclonal antibodies. In situ and invasive melanoma frequently show a diffuse pattern of nuclear PRAME immunoreactivity which contrasts with the infrequent and typically nondiffuse staining seen in nevi. In many challenging melanocytic tumors, results of PRAME IHC and other ancillary tests correlate well, but not always: The tests are not interchangeable. Most metastatic melanomas are positive for PRAME, whereas nodal nevi are not. Numerous studies on PRAME IHC have become available in the past few years with results supporting the value of PRAME IHC as an ancillary tool in the evaluation of melanocytic lesions and providing insights into limitations in sensitivity and specificity as well as possible pitfalls that need to be kept in mind by practicing pathologists.
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Affiliation(s)
- Cecilia Lezcano
- Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
| | - Achim A Jungbluth
- Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY; and
| | - Klaus J Busam
- Pathologist, Department of Pathology and Laboratory Medicine, Memorial Sloan Kettering Cancer Center, New York, NY
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Grand DG, Barton DT, Yan S, Sriharan A, Momtahen S, Cloutier JM, LeBlanc RE. Histiocytoid melanoma: Diagnostic pitfall and mimicker of non-Langerhans cell histiocytoses including reticulohistiocytoma. J Cutan Pathol 2023; 50:647-652. [PMID: 37069790 DOI: 10.1111/cup.14434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Revised: 03/08/2023] [Accepted: 03/22/2023] [Indexed: 04/19/2023]
Abstract
Melanoma and benign histiocytic proliferations can sometimes show considerable clinical and histopathologic overlap. Recently, cases of melanomas resembling xanthogranuloma and Rosai-Dorfman disease have been reported, and herein we report a case of melanoma closely mimicking reticulohistiocytoma. An 84-year-old man presented with a 1 cm purple-red nodule on his arm concerning for squamous cell carcinoma. While the biopsy findings resembled reticulohistiocytoma, the clinical context and regression changes at the lesion perimeter raised stronger concern for melanoma, which was confirmed with immunohistochemistry. We review prior rare reports of melanomas resembling non-Langerhans cell histiocytic proliferations and summarize helpful clinical and histopathologic clues to avoid a diagnostic pitfall when confronted with this unusual quandary.
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Affiliation(s)
- David G Grand
- Department of Dermatology, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Dorothea T Barton
- Department of Dermatology, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Shaofeng Yan
- Department of Pathology and Laboratory Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Aravindhan Sriharan
- Department of Pathology and Laboratory Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Shabnam Momtahen
- Department of Pathology and Laboratory Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Jeffrey M Cloutier
- Department of Pathology and Laboratory Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
| | - Robert E LeBlanc
- Department of Pathology and Laboratory Medicine, Geisel School of Medicine, Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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Gobel RY, Hutabarat EN, Djawad K, Anwar AI, Wahab S, Nurdin A, Idrus I. Accelerated Repigmentation of Halo Nevus Following Excision: A Case Report. Open Access Maced J Med Sci 2023. [DOI: 10.3889/oamjms.2023.11274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
BACKGROUND: Halo nevus is a benign condition characterized by symmetrical oval-shaped and well-defined hypopigmented patch surrounding melanocytic lesions. Their sizes varies from a few millimeters to centimeters. A “wait and see” approach is usually preferred in most cases of halo nevus. However, the condition can cause severe psychological impact and impair patient’s quality of life, especially when it emerges on prominent areas such as the face. Surgical option can be utilized for removal of melanocytic lesions and accelerate regression of the halo.
CASE PRESENTATION: We report a case of a 25-year-old woman with white patches around two moles on her face who was diagnosed as halo nevus. Surgical excision was performed and a 12-week follow-up showed reduction in diameter of the halo nevus.
CONCLUSION: Large halo nevus can cause significant esthetic burden that may affect patient’s quality of life. A more invasive approach such as excision of underlying nevus may be used to achieve more rapid results.
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Chen YP, Zhang WW, Qiu YT, Ke LF, Chen H, Chen G. PRAME is a useful marker for the differential diagnosis of melanocytic tumours and histological mimics. Histopathology 2023; 82:285-295. [PMID: 36200756 DOI: 10.1111/his.14814] [Citation(s) in RCA: 18] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 12/13/2022]
Abstract
AIMS Although the morphological assessment of melanoma is generally straightforward, diagnosis can be especially difficult when the significant morphological and immunohistochemical results overlap with those of benign and malignant melanocytic tumours and histological mimics. This study assessed the potential diagnostic utility of measuring PReferentially expressed Antigen in MElanoma (PRAME) immunohistochemically in naevi, melanomas and clear cell sarcomas (CCSs) in Chinese patients. METHODS We examined the immunohistochemical expression of PRAME in 317 melanocytic naevi, 178 primary melanomas, 72 metastatic melanomas and 19 CCSs and compared the sensitivity and specificity of PRAME immunohistochemistry (IHC) in the differential diagnosis of melanocytic tumours and histological mimics. RESULTS Of the 317 melanocytic naevi, 98.1%were completely negative for PRAME; six cases showed focal PRAME immunoreactivity in a minor population of lesional melanocytes. Diffuse nuclear immunoreactivity for PRAME was found in 89.9% of primary melanomas and 93.1% of metastatic melanomas. Regarding melanoma subtypes, PRAME was expressed in 100% of superficial spreading melanomas, 100% of melanomas arise in congenital naevus, 91.4% of nodular melanomas, 87.8% of acral lentigo melanomas, 80.0% of lentigo malignant melanomas, 60.0% of Spitz melanomas, 96.2% of mucosal melanomas and 80.0% of uveal melanomas. None of the two desmoplastic melanomas expressed PRAME. Of the 19 CCS cases, 89.5% were negative for PRAME and 10.5% showed focal weak PRAME immunoreactivity in a minor population of tumour cells. CONCLUSIONS Our findings indicate that PRAME may be a useful marker to support a suspected diagnosis of melanoma. In addition, lack of PRAME expression is a valuable hint to CCS in a suspected case, and then molecular confirmation of the presence of EWSR1 rearrangement is necessary.
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Affiliation(s)
- Yan-Ping Chen
- Department of Pathology, Clinical Oncology School of Fujian Medical University and Fujian Cancer Hospital, Fuzhou
| | - Wen-Wen Zhang
- Department of Pathology, Clinical Oncology School of Fujian Medical University and Fujian Cancer Hospital, Fuzhou
| | - Ya-Ting Qiu
- Department of Pathology, Clinical Oncology School of Fujian Medical University and Fujian Cancer Hospital, Fuzhou
| | - Long-Feng Ke
- Laboratory of Molecular Pathology, Clinical Oncology School of Fujian Medical University and Fujian Cancer Hospital, Fuzhou
| | - Hao Chen
- Department of Pathology, Hospital for Skin Diseases, Institute of Dermatology, Chinese Academy of Medical Sciences and Peking Union Medical College, Nanjing, China
| | - Gang Chen
- Department of Pathology, Clinical Oncology School of Fujian Medical University and Fujian Cancer Hospital, Fuzhou
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8
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Gerami P, Benton S, Zhao J, Zhang B, Lampley N, Roth A, Boutko A, Olivares S, Busam KJ. PRAME Expression Correlates With Genomic Aberration and Malignant Diagnosis of Spitzoid Melanocytic Neoplasms. Am J Dermatopathol 2022; 44:575-580. [PMID: 35503885 PMCID: PMC11010723 DOI: 10.1097/dad.0000000000002208] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
ABSTRACT Spitzoid melanocytic neoplasms are a diagnostically challenging class of lesions in dermatopathology. Recently, molecular assays and immunohistochemical markers have been explored as ancillary methods to assist in the diagnostic workup. Specifically, preferentially expressed antigen in melanoma (PRAME) immunohistochemistry is a nuclear stain commonly positive in melanomas, but not in nevi. This study investigates PRAME immunoreactivity (≥75% positive nuclear staining in tumor cells) in a set of 59 spitzoid melanocytic neoplasms with known clinical outcomes. We compared PRAME status with (1) the clinical outcomes, (2) the morphologic diagnoses, and (3) the status of TERT promoter mutation. Regarding clinical outcomes, 3 cases developed metastatic disease, of which 2 expressed diffusely positive PRAME staining. Of the 56 cases that did not show evidence of metastasis, 6 expressed diffusely positive PRAME staining. Morphologically, diffusely positive PRAME staining was seen in 7 of 21 cases (33.3%) diagnosed as melanoma and only 1 benign tumor 1 of 38 (2.6%). There were 4 of 8 cases with a TERT promoter mutation which were diffusely PRAME-positive compared with 4 of 51 cases without TERT promoter mutation ( P = 0.001). Our results show a statistically significant correlation between PRAME expression and the diagnosis, outcome, and TERT promoter mutation status of atypical spitzoid melanocytic neoplasms, suggesting immunohistochemistry for PRAME can help support a suspected diagnosis. However, because of occasional false-positive and negative test results, correlation with the clinical and histologic findings as well as results from other tests is needed for the interpretation of diagnostically challenging spitzoid melanocytic neoplasms.
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Affiliation(s)
- Pedram Gerami
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Sarah Benton
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Jeffrey Zhao
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Bin Zhang
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Nathaniel Lampley
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Andrew Roth
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Anastasiya Boutko
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Shantel Olivares
- Department of Dermatology, Feinberg School of Medicine, Northwestern University, Chicago, IL
| | - Klaus J Busam
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, NY
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9
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Plotzke JM, Zoumberos NA, Hrycaj SM, Harms PW, Bresler SC, Chan MP. PRAME Expression is Similar in Scar and Desmoplastic Melanoma. J Cutan Pathol 2022; 49:829-832. [PMID: 35752877 PMCID: PMC9541680 DOI: 10.1111/cup.14286] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2022] [Revised: 06/02/2022] [Accepted: 06/23/2022] [Indexed: 11/30/2022]
Affiliation(s)
| | - Nicholas A Zoumberos
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR
| | - Steven M Hrycaj
- Department of Pathology, University of Michigan, Ann Arbor, MI
| | - Paul W Harms
- Department of Pathology, University of Michigan, Ann Arbor, MI.,Department of Dermatology, University of Michigan, Ann Arbor, MI
| | - Scott C Bresler
- Department of Pathology, University of Michigan, Ann Arbor, MI.,Department of Dermatology, University of Michigan, Ann Arbor, MI
| | - May P Chan
- Department of Pathology, University of Michigan, Ann Arbor, MI.,Department of Dermatology, University of Michigan, Ann Arbor, MI
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Ricci C, Dika E, Ambrosi F, Lambertini M, Veronesi G, Barbara C. Cutaneous Melanomas: A Single Center Experience on the Usage of Immunohistochemistry Applied for the Diagnosis. Int J Mol Sci 2022; 23:5911. [PMID: 35682589 PMCID: PMC9180684 DOI: 10.3390/ijms23115911] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2022] [Revised: 05/16/2022] [Accepted: 05/19/2022] [Indexed: 12/12/2022] Open
Abstract
Cutaneous melanoma (cM) is the deadliest of all primary skin cancers. Its prognosis is strongly influenced by the stage at diagnosis, with early stages having a good prognosis and being potentially treatable with surgery alone; advanced stages display a much worse prognosis, with a high rate of recurrence and metastasis. For this reason, the accurate and early diagnosis of cM is crucial-misdiagnosis may have extremely dangerous consequences for the patient and drastically reduce their chances of survival. Although the histological exam remains the "gold standard" for the diagnosis of cM, a continuously increasing number of immunohistochemical markers that could help in diagnosis, prognostic characterization, and appropriate therapeutical choices are identified every day, with some of them becoming part of routine practice. This review aims to discuss and summarize all the data related to the immunohistochemical analyses that are potentially useful for the diagnosis of cM, thus rendering it easier to appropriately applicate to routine practice. We will discuss these topics, as well as the role of these molecules in the biology of cM and potential impact on diagnosis and treatment, integrating the literature data with the experience of our surgical pathology department.
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Affiliation(s)
- Costantino Ricci
- Pathology Unit, Ospedale Maggiore, 40139 Bologna, Italy; (C.R.); (F.A.)
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40139 Bologna, Italy;
| | - Emi Dika
- Department of Experimental, Diagnostic and Specialty Medicine (DIMES), University of Bologna, 40139 Bologna, Italy;
| | - Francesca Ambrosi
- Pathology Unit, Ospedale Maggiore, 40139 Bologna, Italy; (C.R.); (F.A.)
| | - Martina Lambertini
- Dermatology Unit, IRCCS Policlinico Sant’Orsola-Malpighi, University of Bologna, 40139 Bologna, Italy; (M.L.); (G.V.)
| | - Giulia Veronesi
- Dermatology Unit, IRCCS Policlinico Sant’Orsola-Malpighi, University of Bologna, 40139 Bologna, Italy; (M.L.); (G.V.)
| | - Corti Barbara
- Pathology Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, Policlinico di Sant’Orsola, 40139 Bologna, Italy
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Cazzato G, Mangialardi K, Falcicchio G, Colagrande A, Ingravallo G, Arezzo F, Giliberti G, Trilli I, Loizzi V, Lettini T, Scarcella S, Annese T, Parente P, Lupo C, Casatta N, Maiorano E, Cormio G, Resta L, Ribatti D. Preferentially Expressed Antigen in Melanoma (PRAME) and Human Malignant Melanoma: A Retrospective Study. Genes (Basel) 2022; 13:545. [PMID: 35328098 PMCID: PMC8951616 DOI: 10.3390/genes13030545] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 03/14/2022] [Accepted: 03/17/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Preferentially expressed antigen in melanoma (PRAME) is a cancer testis antigen (CTA) identified in 1997 through analysis of the specificity of tumor-reactive T-cell clones derived from a patient with metastatic cutaneous melanoma. Although at first it seemed even more specific, various studies have shown that PRAME can also be expressed in the context of atypical lesions that do not correspond solely to the definition of malignant melanoma. METHODS A systematic review of English articles was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. RESULTS 126 records were identified in the literature search, of which 9 were duplicates. After screening for eligibility and inclusion criteria, 53 publications were included. CONCLUSIONS The advent of a new marker such as PRAME is surely a step forward not only in the diagnostic approach, but also in the immunotherapeutic approach to MM. However, various studies have shown that PRAME can also be expressed in the context of atypical lesions apart from MM and, for this reason, the diagnostic sensitivity and specificity (hence accuracy) are clearly lower. Further studies with larger case series will be necessary to understand better what possibilities are offered in terms of diagnostic reliability by PRAME.
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Affiliation(s)
- Gerardo Cazzato
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Katia Mangialardi
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Giovanni Falcicchio
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.F.); (F.A.); (V.L.); (G.C.)
| | - Anna Colagrande
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Giuseppe Ingravallo
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Francesca Arezzo
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.F.); (F.A.); (V.L.); (G.C.)
| | - Giovanna Giliberti
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Irma Trilli
- Odontostomatologic Clinic, Department of Innovative Technologies in Medicine and Dentistry, University of Chieti “G. d’Annunzio”, 66100 Chieti, Italy;
| | - Vera Loizzi
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.F.); (F.A.); (V.L.); (G.C.)
| | - Teresa Lettini
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Sara Scarcella
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Tiziana Annese
- Department of Medicine and Surgery, LUM University, 70124 Casamassima, Italy;
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, 70124 Bari, Italy;
| | - Paola Parente
- Pathology Unit, Fondazione IRCCS Casa Sollievo della Sofferenza, 71013 San Giovanni Rotondo, Italy;
| | - Carmelo Lupo
- Innovation Department, Diapath S.p.A, Via Savoldini n.71, 24057 Martinengo, Italy; (C.L.); (N.C.)
| | - Nadia Casatta
- Innovation Department, Diapath S.p.A, Via Savoldini n.71, 24057 Martinengo, Italy; (C.L.); (N.C.)
| | - Eugenio Maiorano
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Gennaro Cormio
- Section of Gynecology and Obstetrics, Department of Biomedical Sciences and Human Oncology (DIMO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (G.F.); (F.A.); (V.L.); (G.C.)
| | - Leonardo Resta
- Section of Pathology, Department of Emergency and Organ Transplantation (DETO), University of Bari “Aldo Moro”, 70124 Bari, Italy; (K.M.); (A.C.); (G.I.); (G.G.); (T.L.); (S.S.); (E.M.); (L.R.)
| | - Domenico Ribatti
- Section of Human Anatomy and Histology, Department of Basic Medical Sciences, Neurosciences and Sensory Organs, University of Bari Medical School, 70124 Bari, Italy;
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12
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Grillini M, Ricci C, Pino V, Pedrini S, Fiorentino M, Corti B. HMB45/PRAME, a Novel Double Staining for the Diagnosis of Melanocytic Neoplasms: Technical Aspects, Results, and Comparison With Other Commercially Available Staining (PRAME and Melan A/PRAME). Appl Immunohistochem Mol Morphol 2022; 30:14-18. [PMID: 34508017 PMCID: PMC9575561 DOI: 10.1097/pai.0000000000000972] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 08/19/2021] [Indexed: 11/26/2022]
Abstract
PRAME (PReferentially expressed Antigen in MElanoma) is a tumor-associated antigen that was recently found to be expressed by malignant melanocytic lesions but not by benign ones, thus resulting useful in this diagnostic field. PRAME could also be expressed by some normal tissues and nonmelanocytic tumors, suggesting as caution should be adopted to use PRAME as a "pan-melanoma" marker for the differential diagnosis with other malignant tumors. Until now, PRAME expression was exclusively investigated through single staining with a monoclonal antibody targeting PRAME and with double staining for Melan A/PRAME found to be useful in specific diagnostic sets. Herein, we studied the expression of PRAME in 40 melanocytic lesions and 23 nonmelanocytic ones using PRAME, Melan A/PRAME, and novel double staining for HMB45/PRAME. Although our results need to be validated, they support the adoption of HMB45/PRAME, alone or in combination with PRAME and Melan A/PRAME, as a helpful marker in the diagnosis of melanocytic neoplasms with a high concordance rate between primary melanoma and corresponding metastases.
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Affiliation(s)
- Marco Grillini
- Pathology Unit, IRCSS Sant’Orsola-Malpighi Hospital and University of Bologna
| | - Costantino Ricci
- Pathology Unit, Maggiore Hospital
- Department of Experimental, Diagnostic, and Specialty Medicine (DIMES), University of Bologna, Bologna, Italy
| | - Vincenzo Pino
- Pathology Unit, IRCSS Sant’Orsola-Malpighi Hospital and University of Bologna
| | - Silvia Pedrini
- Pathology Unit, IRCSS Sant’Orsola-Malpighi Hospital and University of Bologna
| | - Michelangelo Fiorentino
- Pathology Unit, IRCSS Sant’Orsola-Malpighi Hospital and University of Bologna
- Pathology Unit, Maggiore Hospital
| | - Barbara Corti
- Pathology Unit, IRCSS Sant’Orsola-Malpighi Hospital and University of Bologna
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13
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Nedelcu R, Dobre A, Brinzea A, Hulea I, Andrei R, Zurac S, Balaban M, Antohe M, Manea L, Calinescu A, Coman A, Pantelimon F, Dobritoiu A, Popescu C, Popescu R, Balasescu E, Ion D, Turcu G. Current Challenges in Deciphering Sutton Nevi-Literature Review and Personal Experience. J Pers Med 2021; 11:jpm11090904. [PMID: 34575681 PMCID: PMC8470687 DOI: 10.3390/jpm11090904] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 09/01/2021] [Accepted: 09/06/2021] [Indexed: 01/01/2023] Open
Abstract
Halo nevi, known as leukoderma acquisitum centrifugum, Sutton nevus, leukopigmentary nevus, perinevoid vitiligo, or perinevoid leukoderma, together with vitiligo and melanoma-associated hypopigmentation, belong to the group of dermatoses designated as immunological leukodermas. The etiology and pathogenesis of halo nevi has not been fully elucidated. There are several mechanisms through which a lymphocytic infiltrate can induce tumoral regression. In this review, we aimed to update the knowledge about Sutton nevi starting with the clinical appearance and dermoscopic features, continuing with information regarding conventional microscopy, immunohistochemistry, and the immunological mechanisms responsible for the occurrence of halo nevi. We also included in the article original unpublished results when discussing dermoscopic, pathologic and immunohistochemical results in halo nevi. Sutton nevi are valuable models for studying antitumor reactions that the human body can generate. The slow and effective mechanism against a melanocytic skin tumor can teach us important lessons about both autoimmune diseases and anticancer defenses.
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Affiliation(s)
- Roxana Nedelcu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Alexandra Dobre
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Correspondence: ; Tel.: +40-740-853-353
| | - Alice Brinzea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
- National Institute for Infectious Diseases, Outpatient Clinic, 021105 Bucharest, Romania
| | - Ionela Hulea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Razvan Andrei
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Synevo Medical Laboratory, 014192 Bucharest, Romania
| | - Sabina Zurac
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Mihaela Balaban
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Mihaela Antohe
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Lorena Manea
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
- Department of Dermatovenerology, Centre Hospitalier Régional D’orléans, 45100 Orléans, France
| | - Andreea Calinescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Anastasia Coman
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | | | - Adina Dobritoiu
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
| | - Catalin Popescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Raluca Popescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
| | - Elena Balasescu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Daniela Ion
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
| | - Gabriela Turcu
- General Medicine, Carol Davila University of Medicine and Pharmacy, 050474 Bucharest, Romania; (R.N.); (A.B.); (I.H.); (S.Z.); (M.A.); (L.M.); (A.C.); (A.C.); (C.P.); (R.P.); (E.B.); (D.I.); (G.T.)
- Derma 360 Clinic, 11273 Bucharest, Romania; (M.B.); (F.P.); (A.D.)
- Department of Pathology and Dermatovenerology, Colentina Clinical Hospital, 020125 Bucharest, Romania;
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