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García-Onrubia L, Pacheco-Callirgos GE, García-Álvarez C, Muñoz-Moreno MF, García-Lagarto E, Almaraz-Gómez A, Saornil-Álvarez MA. Clinic-pathological agreement in the diagnosis of conjunctival tumours: Analysis of 195 cases. ARCHIVOS DE LA SOCIEDAD ESPANOLA DE OFTALMOLOGIA 2023:S2173-5794(23)00107-X. [PMID: 37369322 DOI: 10.1016/j.oftale.2023.06.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Accepted: 05/07/2023] [Indexed: 06/29/2023]
Abstract
PURPOSE The present study aims to assess the agreement between clinical and pathological diagnosis in conjunctival tumours in a specialist ocular oncology unit. METHODS retrospective study of consecutive patients with conjunctival tumours diagnosed at the Ocular Oncology Unit of the University Hospital of Valladolid was performed from 1992 to 2017. Tumours were classified according to their origin (epithelial, melanocytic, lymphoid and others) and degree of malignancy (benign, premalignant, malignant). A biopsy was performed in cases of symptomatic or growing lesions. Cohen´s kappa (κ) statistics was used as an indicator of agreement between clinical and pathological diagnosis. RESULTS Of 462 consecutive patients, a biopsy was required in 195 (42.2%). The agreement with the pathological diagnosis was successful in 154 (79.0%) cases. Analysis according to the grade of malignancy showed the lowest rate of agreement among benign (n = 83; 91.6%) and premalignant (n = 62; 90.3%) lesions, with a total agreement in malignant lesions (n = 50; 100%); the Cohen´s kappa coefficient (κ) was 0.90. The highest rates of concordance were found in epithelial, melanocytic and soft tissue lesions with κ values of 1, 0.8 and 1 respectively. The worst rate of concordance was found in lymphoid lesions with a κ value of 0.3. CONCLUSION Most of the conjunctival tumours were correctly identified clinically; benign and malignant lesions showed the highest rate of accuracy; however, premalignant tumours can hide micro-invasive diseases that can go unnoticed on clinical examination. The biopsy is essential for accurate diagnosis and treatment.
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Affiliation(s)
- L García-Onrubia
- Unidad de Tumores Oculares, Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain; Moorfields Eye Hospital NHS Foundation Trust, Londres, United Kingdom.
| | - G E Pacheco-Callirgos
- Unidad de Tumores Oculares, Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - C García-Álvarez
- Unidad de Tumores Oculares, Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - M F Muñoz-Moreno
- Unidad de Tumores Oculares, Unidad de Investigación, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - E García-Lagarto
- Departamento de Patología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
| | - A Almaraz-Gómez
- Departamento de Epidemiología y Medicina Preventiva, Facultad de Medicina, Universidad de Valladolid, Valladolid, Spain
| | - M A Saornil-Álvarez
- Unidad de Tumores Oculares, Departamento de Oftalmología, Hospital Clínico Universitario de Valladolid, Valladolid, Spain
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Bălăşoiu AT, Ştefănescu-Dima AŞ, Bălăşoiu M, Ciurea RN, Muraru A, Dan AO, Simionescu CE. Locally advanced choroidal melanoma with favorable molecular prognosis - case report. ROMANIAN JOURNAL OF MORPHOLOGY AND EMBRYOLOGY = REVUE ROUMAINE DE MORPHOLOGIE ET EMBRYOLOGIE 2022; 63:645-652. [PMID: 36808200 PMCID: PMC10026924 DOI: 10.47162/rjme.63.4.07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
Uveal malignant melanoma is a rare malignant tumor comprising less than 5% of melanoma cases. It is nevertheless the intraocular tumor with the highest incidence in adults, that arises from the melanocytes in the uveal tract. The authors present the case of a patient with locally advanced choroidal melanoma: from presentation to diagnosis, treatment, and prognosis. A 63-year-old female patient presented in the Ambulatory of the Emergency County Hospital, Craiova, Romania, on the February 1, 2021, accusing visual acuity drop and photophobia in her left eye for about three weeks. Pathology examination in Hematoxylin-Eosin (HE) staining reveals a dense cell proliferation, with small and medium spindle cells and pigment production. The following immunohistochemical markers were used in our study: human melanoma black 45 (HMB45), Ki67, cyclin D1, B-cell lymphoma 2 (Bcl2), S100, Wilms' tumor 1 (WT1), p16, and p53. Uveal melanoma is a malignant tumor that can arise in all the uveal components: iris, ciliary body, and choroid. Out of the three components, iris melanomas have the best prognosis, while ciliary body melanomas have the worst prognosis. It is mandatory for the patient to respect the follow-up schedule, as follow-ups can provide early diagnosis of eventual metastasis.
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Affiliation(s)
- Andrei Theodor Bălăşoiu
- Department of Pathology, Department of Ophthalmology, University of Medicine and Pharmacy of Craiova, Romania; ;
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Mahaling B, Low SWY, Beck M, Kumar D, Ahmed S, Connor TB, Ahmad B, Chaurasia SS. Damage-Associated Molecular Patterns (DAMPs) in Retinal Disorders. Int J Mol Sci 2022; 23:ijms23052591. [PMID: 35269741 PMCID: PMC8910759 DOI: 10.3390/ijms23052591] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 02/22/2022] [Accepted: 02/25/2022] [Indexed: 12/13/2022] Open
Abstract
Damage-associated molecular patterns (DAMPs) are endogenous danger molecules released from the extracellular and intracellular space of damaged tissue or dead cells. Recent evidence indicates that DAMPs are associated with the sterile inflammation caused by aging, increased ocular pressure, high glucose, oxidative stress, ischemia, mechanical trauma, stress, or environmental conditions, in retinal diseases. DAMPs activate the innate immune system, suggesting their role to be protective, but may promote pathological inflammation and angiogenesis in response to the chronic insult or injury. DAMPs are recognized by specialized innate immune receptors, such as receptors for advanced glycation end products (RAGE), toll-like receptors (TLRs) and the NOD-like receptor family (NLRs), and purine receptor 7 (P2X7), in systemic diseases. However, studies describing the role of DAMPs in retinal disorders are meager. Here, we extensively reviewed the role of DAMPs in retinal disorders, including endophthalmitis, uveitis, glaucoma, ocular cancer, ischemic retinopathies, diabetic retinopathy, age-related macular degeneration, rhegmatogenous retinal detachment, proliferative vitreoretinopathy, and inherited retinal disorders. Finally, we discussed DAMPs as biomarkers, therapeutic targets, and therapeutic agents for retinal disorders.
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Affiliation(s)
- Binapani Mahaling
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
| | - Shermaine W. Y. Low
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
| | - Molly Beck
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
| | - Devesh Kumar
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
| | - Simrah Ahmed
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
| | - Thomas B. Connor
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
- Vitreoretinal Surgery, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Baseer Ahmad
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
- Vitreoretinal Surgery, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA
| | - Shyam S. Chaurasia
- Ocular Immunology and Angiogenesis Lab, Department of Ophthalmology and Visual Sciences, Froedtert and MCW Eye Institute, Medical College of Wisconsin, Milwaukee, WI 53226, USA; (B.M.); (S.W.Y.L.); (M.B.); (D.K.); (S.A.); (T.B.C.); (B.A.)
- Department of Cell Biology, Neurobiology and Anatomy, Medical College of Wisconsin, Milwaukee, WI 53226, USA
- Correspondence: ; Tel.: +1-414-955-2050
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Gu C, Gu X, Wang Y, Yao Z, Zhou C. Construction and Validation of a Novel Immunosignature for Overall Survival in Uveal Melanoma. Front Cell Dev Biol 2021; 9:710558. [PMID: 34552928 PMCID: PMC8450517 DOI: 10.3389/fcell.2021.710558] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Accepted: 08/18/2021] [Indexed: 11/16/2022] Open
Abstract
Objectives Uveal melanoma (UM) is the most common primary intraocular malignancy in adults, and immune infiltration plays a crucial role in the prognosis of UM. This study aimed to generate an immunological marker-based predictive signature for the overall survival (OS) of UM patients. Methods Single-sample gene-set enrichment analysis (ssGSEA) was used to profile immune cell infiltration in 79 patients with UM from The Cancer Genome Atlas (TCGA) database. Univariate and multivariate least absolute shrinkage and selection operator (LASSO) Cox regressions were used to determine the prognostic factors for UM and construct the predictive immunosignature. Receiver operating characteristic (ROC) curves, decision curve analysis (DCA), and calibration curves were performed to evaluate the clinical ability and accuracy of the model. In addition, the predictive accuracy was compared between the immunosignature and the Tumor, Node, Metastasis (TNM) staging system of American Joint Committee on Cancer (AJCC). We further analyzed the differences in clinical characteristics, immune infiltrates, immune checkpoints, and therapy sensitivity between high- and low-risk groups characterized by the prognostic model. Results Higher levels of immune cell infiltration in UM were related to a lower survival rate. Matrix metallopeptidase 12 (MMP12), TCDD inducible poly (ADP-ribose) polymerase (TIPARP), and leucine rich repeat neuronal 3 (LRRN3) were identified as prognostic signatures, and an immunological marker-based prognostic signature was constructed with good clinical ability and accuracy. The immunosignature was developed with a concordance index (C-index) of 0.881, which is significantly better than that of the TNM staging system (p < 0.001). We further identified 1,762 genes with upregulated expression and 798 genes with downregulated expression in the high-risk group, and the differences between the high- and low-risk groups were mainly in immune-related processes. In addition, the expression of most of the immune checkpoint-relevant and immune activity-relevant genes was significantly higher in the high-risk group, which was more sensitive to therapy. Conclusion We developed a novel immunosignature constructed by MMP12, TIPARP, and LRRN3 that could effectively predict the OS of UM.
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Affiliation(s)
- Chufeng Gu
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Xin Gu
- Department of Ophthalmology, Suzhou TCM Hospital Affiliated to Nanjing University of Chinese Medicine, Suzhou, China
| | - Yujie Wang
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
| | - Zhixian Yao
- Department of Urology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Chuandi Zhou
- Department of Ophthalmology, Shanghai General Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,National Clinical Research Center for Eye Diseases, Shanghai Key Laboratory of Ocular Fundus Diseases, Shanghai Engineering Center for Visual Science and Photomedicine, Shanghai Engineering Center for Precise Diagnosis and Treatment of Eye Diseases, Shanghai, China
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Koç İ, Kıratlı H. Current Management of Conjunctival Melanoma Part 2: Treatment and Future Directions. Turk J Ophthalmol 2021; 50:362-370. [PMID: 33389937 PMCID: PMC7802095 DOI: 10.4274/tjo.galenos.2020.22567] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Conjunctival melanoma is a rare disease which requires tailored management in most cases. The mainstays of treatment can be classified as surgery, topical chemotherapy, radiotherapy, cryotherapy, and other emerging treatment modalities. Herein we review conventional approaches as well as more recently introduced treatment options, together with advances in molecular biology in this particular disease.
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Affiliation(s)
- İrem Koç
- Hacettepe University Faculty of Medicine, Department of Ophthalmology, Ocular Oncology Unit, Ankara, Turkey
| | - Hayyam Kıratlı
- Hacettepe University Faculty of Medicine, Department of Ophthalmology, Ocular Oncology Unit, Ankara, Turkey
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RAGE Signaling in Melanoma Tumors. Int J Mol Sci 2020; 21:ijms21238989. [PMID: 33256110 PMCID: PMC7730603 DOI: 10.3390/ijms21238989] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 11/22/2020] [Accepted: 11/23/2020] [Indexed: 12/18/2022] Open
Abstract
Despite recent progresses in its treatment, malignant cutaneous melanoma remains a cancer with very poor prognosis. Emerging evidences suggest that the receptor for advance glycation end products (RAGE) plays a key role in melanoma progression through its activation in both cancer and stromal cells. In tumors, RAGE activation is fueled by numerous ligands, S100B and HMGB1 being the most notable, but the role of many other ligands is not well understood and should not be underappreciated. Here, we provide a review of the current role of RAGE in melanoma and conclude that targeting RAGE in melanoma could be an approach to improve the outcomes of melanoma patients.
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Tsering T, Laskaris A, Abdouh M, Bustamante P, Parent S, Jin E, Ferrier ST, Arena G, Burnier JV. Uveal Melanoma-Derived Extracellular Vesicles Display Transforming Potential and Carry Protein Cargo Involved in Metastatic Niche Preparation. Cancers (Basel) 2020; 12:cancers12102923. [PMID: 33050649 PMCID: PMC7600758 DOI: 10.3390/cancers12102923] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2020] [Revised: 10/05/2020] [Accepted: 10/07/2020] [Indexed: 12/13/2022] Open
Abstract
Extracellular vesicles (EVs) carry molecules derived from donor cells and are able to alter the properties of recipient cells. They are important players during the genesis and progression of tumors. Uveal melanoma (UM) is the most common primary intraocular tumor in adults and is associated with a high rate of metastasis, primarily to the liver. However, the mechanisms underlying this process are poorly understood. In the present study, we analyzed the oncogenic potential of UM-derived EVs and their protein signature. We isolated and characterized EVs from five UM cell lines and from normal choroidal melanocytes (NCMs). BRCA1-deficient fibroblasts (Fibro-BKO) were exposed to the EVs and analyzed for their growth in vitro and their reprograming potential in vivo following inoculation into NOD-SCID mice. Mass spectrometry of proteins from UM-EVs and NCM-EVs was performed to determine a protein signature that could elucidate potential key players in UM progression. In-depth analyses showed the presence of exosomal markers, and proteins involved in cell-cell and focal adhesion, endocytosis, and PI3K-Akt signaling pathway. Notably, we observed high expression levels of HSP90, HSP70 and integrin V in UM-EVs. Our data bring new evidence on the involvement of UM-EVs in cancer progression and metastasis.
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Affiliation(s)
- Thupten Tsering
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Alexander Laskaris
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Mohamed Abdouh
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Prisca Bustamante
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Sabrina Parent
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Eva Jin
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Sarah Tadhg Ferrier
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
| | - Goffredo Arena
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
- Ospedale Giuseppe Giglio Fondazione San Raffaele Cefalu Sicily, 90015 Cefalu, Italy
- Mediterranean Institute of Oncology, 95029 Viagrande, Italy
| | - Julia V. Burnier
- Cancer Research Program, Research Institute of the McGill University Health Centre, 1001 Decarie Blvd, Montreal, QC H4A 3J1, Canada; (T.T.); (A.L.); (M.A.); (P.B.); (S.P.); (E.J.); (S.T.F.); (G.A.)
- Experimental Pathology Unit, Department of Pathology, McGill University, QC H3A 2B4, Canada
- Correspondence: ; Tel.: +1-514-934-1934 (ext. 76307)
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Mikkelsen LH. Molecular biology in conjunctival melanoma and the relationship to mucosal melanoma. Acta Ophthalmol 2020; 98 Suppl 115:1-27. [PMID: 32749776 DOI: 10.1111/aos.14536] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Affiliation(s)
- Lauge Hjorth Mikkelsen
- Eye Pathology Section; Departments of Pathology and Ophthalmology, Rigshospitalet; Copenhagen University Hospital; Copenhagen Denmark
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Soon AK, Brownstein S, Tang T, Saleh S, Jiang K, Levac J, Blanco P, Farmer J. Immunohistochemical analysis of benign and malignant melanocytic lesions of the conjunctiva using double-staining. Can J Ophthalmol 2019; 54:699-707. [PMID: 31836103 DOI: 10.1016/j.jcjo.2019.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2018] [Revised: 03/02/2019] [Accepted: 03/25/2019] [Indexed: 10/26/2022]
Abstract
OBJECTIVE To implement a double-staining technique to identify the most sensitive and specific combinations of melanoma antigen recognized by T cells (Melan-A), microphthalmia-associated transcription factor (MITF), human melanoma black 45 (HMB45), and Ki67 aiming to assist in the diagnosis of atypical melanocytic conjunctival lesions that are more prone to malignant progression. METHODS Eight specimens of conjunctival melanoma and of primary acquired melanosis with moderate to severe atypia were double-immunostained with a combination of a cytoplasmic marker (anti-Melan-A or anti-HMB45), and a nuclear marker (anti-MITF or anti-Ki67). Eight specimens of normal conjunctiva and of conjunctival nevi served as controls. The specimens were processed using 3,3-diaminobenzidine substrate for nuclear stains and the fast-red substrate for cytoplasmic stains. Each slide was analyzed by light microscopy and provided a percent scale and a 0 to 4+ score for each nuclear and cytoplasmic component. RESULTS Melan-A and MITF were strongly positive markers for all melanocytic cells, whereas Ki67 and HMB45 provided a variable response for identifying potentially proliferative or aggressive cells. HMB45 and MITF proved to be the best combination for differentiating between atypical and benign lesions on a percent scale and a 0 to 4+ scale (p = 0.0004), with the 3 other combinations providing mainly confirmatory diagnostic information (p < 0.05). CONCLUSIONS Our study used an immunohistochemical double-staining approach to differentiate between atypical and benign melanocytic lesions of the conjunctiva. Our findings should aid in a more complete immunohistopathological diagnosis of conjunctival melanocytic lesions, particularly in diagnostically difficult cases.
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Affiliation(s)
- Alexander K Soon
- Department of Ophthalmology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont.; Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - Seymour Brownstein
- Department of Ophthalmology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont.; Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont..
| | - Tina Tang
- Department of Ophthalmology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont.; Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - Solin Saleh
- Department of Ophthalmology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont.; Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - Kailun Jiang
- Department of Ophthalmology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont.; Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - Joelle Levac
- Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - Paula Blanco
- Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
| | - James Farmer
- Department of Ophthalmology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont.; Department of Pathology, The Ottawa Hospital, University of Ottawa, Ottawa, Ont
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Reddy HS, Keene CD, Chang SH, Jian-Amadi A, Cimino PJ. Immunohistochemical profiling including beta-catenin in conjunctival melanocytic lesions. Exp Mol Pathol 2017; 102:198-202. [PMID: 28161440 DOI: 10.1016/j.yexmp.2017.01.016] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Accepted: 01/28/2017] [Indexed: 01/11/2023]
Abstract
Conjunctival melanocytic lesions encompass a group of clinically diverse, benign to malignant, neoplasms that may contain overlapping histopathological features, making definitive diagnosis challenging in some cases. In this series, we compared multiple immunohistochemical (IHC) markers in 11 conjunctival nevi, 10 primary acquired melanosis (PAM) lesions, and 11 conjunctival melanomas. Immunostains included the melanocytic markers HMB-45 and Melan-A, as well as the proliferative marker Ki-67. Loss of beta-catenin expression has been associated with more aggressive clinical disease in cutaneous melanoma, but its status in conjunctival melanocytic lesions is not known, therefore we incorporated beta-catenin immunohistochemical staining in our study. In this series, conjunctival melanomas had a higher Ki-67 proliferative index and HMB-45 immunoreactivity than did PAM lesions and conjunctival nevi (P<0.001). Melan-A was highly expressed in all 3 groups. Beta-catenin was more strongly expressed in melanomas and nevi than in PAM (P<0.001). There was high inter-grader reliability (Kappa=0.53). Overall, IHC labeling of HMB-45 and Ki-67 is increased in conjunctival melanomas compared to PAM or conjunctival nevi. Beta-catenin, an IHC marker previously unstudied in conjunctival melanocytic lesions, is not preferentially expressed in benign lesions and may play a different role in conjunctival atypia than it does in cutaneous melanoma.
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Affiliation(s)
- Harsha S Reddy
- Ophthalmic Plastic and Reconstructive Surgery, New York Eye and Ear Infirmary of Mount Sinai, New York, NY, United States
| | - C Dirk Keene
- Department of Ophthalmology, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA, United States; Department of Pathology, Division of Neuropathology, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA, United States
| | - Shu H Chang
- Department of Ophthalmology, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA, United States
| | - Arash Jian-Amadi
- Department of Ophthalmology, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA, United States
| | - Patrick J Cimino
- Department of Pathology, Division of Neuropathology, University of Washington School of Medicine and Harborview Medical Center, Seattle, WA, United States.
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The Role for Sentinel Lymph Node Biopsy in the Management of Conjunctival Melanoma. Int Ophthalmol Clin 2016; 57:87-101. [PMID: 27898616 DOI: 10.1097/iio.0000000000000161] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
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12
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Vora GK, Demirci H, Marr B, Mruthyunjaya P. Advances in the management of conjunctival melanoma. Surv Ophthalmol 2016; 62:26-42. [PMID: 27321895 DOI: 10.1016/j.survophthal.2016.06.001] [Citation(s) in RCA: 68] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2016] [Accepted: 06/07/2016] [Indexed: 12/28/2022]
Abstract
Malignant melanoma of the conjunctiva is a rare but serious condition. Over the last several years, there have been important advances in the classification, diagnosis, and treatment of this condition. Recent cytogenetic and immunohistochemical studies are increasing understanding of its tumorigenesis. Diagnosis, although still made via histopathology, has been aided with imaging techniques such as ultrasound biomicroscopy and anterior segment optical coherence tomography. Primary treatment consists of surgical excision. But adjuvant treatments with cryotherapy, topical chemotherapy, and radiation therapy have shown increased success. Sentinel lymph node biopsy has shown early promise of detecting micro-metastasis. Long term follow-up of patients with conjunctival melanoma with systemic surveillance is necessary to detect recurrences and metastases.
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Affiliation(s)
- Gargi K Vora
- Department of Ophthalmology, Duke University, Durham, North Carolina, USA
| | - Hakan Demirci
- Department of Ophthalmology and Visual Sciences, W.K. Kellogg Eye Center, University of Michigan, Ann Arbor, Michigan, USA
| | - Brian Marr
- Department of Surgery, Memorial Sloan Kettering Cancer Center, Ophthalmic Oncology Service Weill-Cornell Medical School, New York, New York, USA
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Esposito E, Zoroquiain P, Mastromonaco C, Morales MC, Belfort Neto R, Burnier M. Epithelial Inclusion Cyst in Conjunctival Melanoma. Int J Surg Pathol 2016; 24:562-7. [PMID: 27160434 DOI: 10.1177/1066896916648381] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Conjunctival melanoma is the second most common conjunctival malignancy. Its differential diagnosis with other conjunctival melanocytic neoplasms is inherently difficult. The presence of epithelial cysts is a useful feature in conjunctival tumors and favors a benign lesion. Herein 2 cases of conjunctival melanoma with cysts are presented. To the best of our knowledge, this is the first series of conjunctival melanoma with epithelial inclusion cysts. This series emphasizes the importance of considering several malignant features when reviewing conjunctival melanocytic lesions, as malignancy can exist even in the presence of epithelial inclusion cysts.
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Affiliation(s)
| | - Pablo Zoroquiain
- McGill University, Montreal, Quebec, Canada Pontificia Universidad Catolica de Chile, Santiago, Chile
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Jakobiec FA. Conjunctival Primary Acquired Melanosis: Is It Time for a New Terminology? Am J Ophthalmol 2016; 162:3-19.e1. [PMID: 26556007 DOI: 10.1016/j.ajo.2015.11.003] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Revised: 10/28/2015] [Accepted: 11/03/2015] [Indexed: 01/21/2023]
Abstract
PURPOSE To review the diagnostic categories of a group of conditions referred to as "primary acquired melanosis." DESIGN Literature review on the subject and proposal of an alternative diagnostic schema with histopathologic and immunohistochemical illustrations. METHODS Standard hematoxylin-eosin-stained sections and immunohistochemical stains for MART-1, HMB-45, microphthalmia-associated transcription factor (MiTF), and Ki-67 for calculating the proliferation index are illustrated. RESULTS "Melanosis" is an inadequate and misleading term because it does not distinguish between conjunctival intraepithelial melanin overproduction ("hyperpigmentation") and intraepithelial melanocytic proliferation. It is recommended that "intraepithelial melanocytic proliferation" be adopted for histopathologic diagnosis. Atypical proliferations are characterized either by bloated dendritic melanocytes with enlarged cell components (dendrites, cell bodies, and nuclei) or by epithelioid melanocytes without dendrites. Atypical polygonal or epithelioid pagetoid cells may reach higher levels of the epithelium beyond the basal layer. Immunohistochemistry defines the degree of melanocytic proliferation or the cellular shape (dendritic or nondendritic) (MART-1, HMB-45) or identifies the melanocytic nuclei (MiTF). Intraepithelial melanocytic proliferation without atypia represents increased numbers of normal-appearing dendritic melanocytes (hyperplasia or early neoplasia) that generally remain confined to the basal/basement membrane region. Intraepithelial nonproliferative melanocytic pigmentation signifies the usually small number of conjunctival basal dendritic melanocytes that synthesize increased amounts of melanin that is transferred to surrounding keratinocytes. CONCLUSION All pre- and postoperative biopsies of flat conjunctival melanocytic disorders should be evaluated immunohistochemically if there is any question regarding atypicality. This should lead to a clearer microscopic descriptive diagnosis that is predicated on an analysis of the participating cell types and their architectural patterns. This approach is conducive to a better appreciation of features indicating when to intervene therapeutically. An accurate early diagnosis should forestall unnecessary later surgery.
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Affiliation(s)
- Frederick A Jakobiec
- David G. Cogan Laboratory of Ophthalmic Pathology, Massachusetts Eye and Ear Infirmary and the Department of Ophthalmology, Massachusetts Eye and Ear Infirmary and Harvard Medical School, Boston, Massachusetts.
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15
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Leśniak W, Graczyk-Jarzynka A. The S100 proteins in epidermis: Topology and function. Biochim Biophys Acta Gen Subj 2015; 1850:2563-72. [PMID: 26409143 DOI: 10.1016/j.bbagen.2015.09.015] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 09/20/2015] [Indexed: 12/21/2022]
Abstract
BACKGROUND S100 proteins are small calcium binding proteins encoded by genes located in the epidermal differentiation complex (EDC). Differently to other proteins encoded by EDC genes, which are indispensable for normal epidermal differentiation, the role of S100 proteins in the epidermis remains largely unknown. SCOPE OF REVIEW Particular S100 proteins differ in their distribution in epidermal layers, skin appendages, melanocytes and Langerhans cells. Taking into account that each epidermal component consists of specialized cells with well-defined functions, such differential distribution may be indicative of the function of a given S100 protein. We used this criterion together with the survey of the current experimental data pertinent to epidermis to provide a fairly comprehensive view on the possible function of individual S100 proteins in this tissue. MAJOR CONCLUSIONS S100 proteins are differently expressed and, despite extensive structural homology, perform diverse functions in the epidermis. Certain S100 proteins probably ensure constant epidermal renewal and support wound healing while others act in epidermal differentiation or have a protective role. As their expression is differently affected in various skin pathologies, particular S100 proteins could be valuable diagnostic markers. GENERAL SIGNIFICANCE S100 proteins seem to be important although not yet fully recognized epidermal constituents. Better understanding of their role in the epidermis might be helpful in designing therapies to various skin diseases.
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Affiliation(s)
- Wiesława Leśniak
- Department of Molecular and Cellular Neurobiology, Nencki Institute of Experimental Biology, 3 Pasteur Street, 02-093 Warsaw, Poland.
| | - Agnieszka Graczyk-Jarzynka
- Department of Molecular and Cellular Neurobiology, Nencki Institute of Experimental Biology, 3 Pasteur Street, 02-093 Warsaw, Poland
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16
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Schiffner S, Braunger BM, de Jel MM, Coupland SE, Tamm ER, Bosserhoff AK. Tg(Grm1) transgenic mice: a murine model that mimics spontaneous uveal melanoma in humans? Exp Eye Res 2014; 127:59-68. [PMID: 25051141 DOI: 10.1016/j.exer.2014.07.009] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2014] [Revised: 07/11/2014] [Accepted: 07/12/2014] [Indexed: 10/25/2022]
Abstract
Although rare, uveal melanoma (UM) is the most common primary intraocular tumor in adults. About half of UM patients develop metastatic disease typically in the liver and die within a short period, due to ineffective systemic therapies. UM has unique and distinct genetic features predictive of metastasis. Animal models are required to improve our understanding of therapeutic options in disseminated UM. Since spontaneous murine UM models are lacking, our aim was to analyze the suitability of the established transgenic melanoma mouse model Tg(Grm1) as a new UM model system. We demonstrated that adult Grm1 transgenic mice develop choroidal thickening and uveal melanocytic neoplasia with expression of the melanocytic markers S100B and MelanA. Further, we showed that GRM1 is expressed in human UM, similar to skin melanoma. This study presents a new mouse model for spontaneous UM and suggests that the glutamate signaling pathway is a possible target for UM therapy.
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Affiliation(s)
- Susanne Schiffner
- University of Regensburg, Institute of Pathology, Molecular Pathology, Franz-Joseph-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Barbara M Braunger
- University of Regensburg, Institute of Human Anatomy and Embryology, Universitaetsstraße 31, 93053 Regensburg, Germany
| | - Miriam M de Jel
- University of Regensburg, Institute of Pathology, Molecular Pathology, Franz-Joseph-Strauss-Allee 11, 93053 Regensburg, Germany
| | - Sarah E Coupland
- University of Liverpool, Institute of Translational Medicine, Molecular and Clinical Cancer Medicine, Daulby Street, Liverpool L69 3GA, United Kingdom
| | - Ernst R Tamm
- University of Regensburg, Institute of Human Anatomy and Embryology, Universitaetsstraße 31, 93053 Regensburg, Germany
| | - Anja K Bosserhoff
- University of Regensburg, Institute of Pathology, Molecular Pathology, Franz-Joseph-Strauss-Allee 11, 93053 Regensburg, Germany.
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17
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Ordóñez NG. Value of melanocytic-associated immunohistochemical markers in the diagnosis of malignant melanoma: a review and update. Hum Pathol 2014; 45:191-205. [PMID: 23648379 DOI: 10.1016/j.humpath.2013.02.007] [Citation(s) in RCA: 107] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2013] [Revised: 02/12/2013] [Accepted: 02/15/2013] [Indexed: 11/21/2022]
Abstract
Since the identification of S100 protein as an immunohistochemical marker that could be useful in the diagnosis of melanoma in the early 1980s, a large number of other melanocytic-associated markers that could potentially be used to assist in the differential diagnosis of these tumors have also been investigated. A great variation exists, however, among these markers, not only in their expression in some subtypes of melanoma, particularly desmoplastic melanoma, but also in their specificity because some of them can also be expressed in nonmelanocytic neoplasms, including various types of soft tissue tumors and carcinomas. This article reviews the information that is currently available on the practical value of some of the markers that have more often been recommended for assisting in the diagnosis of melanomas, including those that have only recently become available.
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Affiliation(s)
- Nelson G Ordóñez
- Department of Pathology, The University of Texas MD Anderson Cancer Center, 1515 Holcombe Blvd, Houston, TX 77030.
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19
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Lim LA, Madigan MC, Conway RM. Conjunctival melanoma: a review of conceptual and treatment advances. Clin Ophthalmol 2013; 6:521-31. [PMID: 23515569 PMCID: PMC3601642 DOI: 10.2147/opth.s38415] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The aim of this study was to review the available literature and identify recent advances in the
classification and management of conjunctival melanoma (CM) for clinicians working in this field.
English-based articles were identified using the MEDLINE® database, and
additional cited works not detected in the initial search were also obtained. Articles were assessed
according to the Australian National Health and Medical Research Council levels of evidence
criteria. Review of the literature indicated that the current classification and management of CM is
predominantly based upon primarily nonrandomized, single-institution, retrospective case series.
While these studies provide the basis for the recent seventh edition of the tumor node metastasis
staging classification, this classification more accurately reflects the current knowledge of
prognostic factors for CM. Application of this revised classification system together with
prospective trials will provide the opportunity for future consistent and comparable data collection
across centers, and it will improve the quality of evidence upon which current classification and
management of CM is based. Furthermore, the high risk of local recurrence with current standard
management suggests that adjuvant therapy, particularly mitomycin C and/or brachytherapy, may
improve outcomes regardless of clinical staging. Finally, the use of sentinel lymph node biopsy may
have significant benefit for a select group of CM patients.
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Affiliation(s)
- Li-Anne Lim
- Save Sight Institute, Clinical Ophthalmology, The University of Sydney, Sydney, New South Wales, Australia
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20
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Zoroquiain P, Fernandes BF, González S, Novais GN, Schalper KA, Burnier MN. p16ink4a Expression in Benign and Malignant Melanocytic Conjunctival Lesions. Int J Surg Pathol 2012; 20:240-245. [DOI: 10.1177/1066896911435697] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/30/2023]
Abstract
Acquired conjunctival melanocytic lesions include nevi, primary acquired melanoses (PAMs), and melanomas. Conjunctival melanoma is a malignant melanocytic neoplasm with a high metastasis and mortality rate. Usually, the diagnosis can be achieved only with routine microscopic analysis, but in some cases, the samples are small or have artifacts. In these cases, complementary studies will be helpful, but currently, there are no well-understood or studied complementary methods. Objective. To analyze the immunohistochemical expression of p16 in conjunctival melanocytic lesions and to assess its potential for differentiating between benign and malignant melanocytic lesions. Methods. Immunohistochemical study against p16ink4a (p16) was performed on paraffin-embedded sections on 45 melanocytic lesions (9 melanomas, 19 nevi, and 2 PAMs with atypia and 15 without atypia). Expression was scored according to the German immunoreactive score (IRS). Results. Expression of p16 IRS differed between nevi, PAMs, and melanomas. The mean IRS for melanomas was 3.3 ± 1.8 and was lower than those for nevi (7.63 ± 3.24; P < .05), PAM with atypia (12 ± 0; P < .05), and PAM without atypia (11 ± 1.69; P < .05). Lesions with infiltration depths lower than 2 mm showed higher levels of p16. There were no differences between favorable and unfavorable locations. Conclusion. p16 Expression in conjunctival melanocytic lesions showed an expression similar to that in skin and seems to be a good marker to differentiate nevi and PAMs from melanomas. However, additional studies of larger series and follow-up are needed to confirm these findings.
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Affiliation(s)
- Pablo Zoroquiain
- The Henry C. Witelson Ocular Pathology Laboratory, Montreal, Canada
- Pontificia Universidad Católica de Chile, Santiago, Chile
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Affiliation(s)
- Brian R Cannon
- University of Maryland, Baltimore, MD, USA (BRC, DJW); Texas A&M University, College Station, TX, USA (DBZ)
| | - Danna B Zimmer
- University of Maryland, Baltimore, MD, USA (BRC, DJW); Texas A&M University, College Station, TX, USA (DBZ)
| | - David J Weber
- University of Maryland, Baltimore, MD, USA (BRC, DJW); Texas A&M University, College Station, TX, USA (DBZ)
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Abstract
Abstract
Context—Melanocytic proliferations are among the most common neoplasms of the conjunctiva. They often represent challenging lesions for pathologists unfamiliar with unique histologic features of melanocytic proliferations in this location and with nomenclature used by ophthalmologists.
Objective—To comprehensively review clinical aspects, pathologic features, and management of melanocytic proliferations of the conjunctiva.
Data Sources—Review of the literature and personal experience of the authors.
Conclusions—Classification, state of the art, and practical aspects of pathology of melanocytic proliferations of the conjunctiva are discussed.
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23
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Immunohistochemical analysis of the S100A1, S100B, CD44 and Bcl-2 antigens and the rate of cell proliferation assessed by Ki-67 antibody in benign and malignant melanocytic tumours. Melanoma Res 2010; 20:118-25. [DOI: 10.1097/cmr.0b013e3283350554] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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24
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Busam KJ, Fang Y, Jhanwar SC, Pulitzer MP, Marr B, Abramson DH. Distinction of conjunctival melanocytic nevi from melanomas by fluorescence in situ hybridization. J Cutan Pathol 2010; 37:196-203. [DOI: 10.1111/j.1600-0560.2009.01488.x] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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25
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Gambichler T, Grothe S, Rotterdam S, Altmeyer P, Kreuter A. Protein expression of carcinoembryonic antigen cell adhesion molecules in benign and malignant melanocytic skin lesions. Am J Clin Pathol 2009; 131:782-7. [PMID: 19461083 DOI: 10.1309/ajcp24kxjvbzxens] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Dysregulation of cell adhesion molecules is associated with progression of malignant melanoma. Immunohistologic study of benign nevi (BN), dysplastic nevi (DN), and primary superficial spreading melanoma (SSM) was performed for carcinoembryonic antigen (CEA) and CEA cell adhesion molecule-1 (CEACAM1) using monoclonal antibodies. We investigated BN (n = 42), DN (n = 22), thin SSM (n = 21), and thick SSM (n = 21). CEA expression in melanomas and DN was significantly increased compared with BN. CEA expression in thick SSM was significantly higher than in DN. Compared with BN, expression of CEACAM1 in melanomas was significantly increased. CEACAM1 expression in thick SSM was significantly increased compared with DN and thin SSM. Our data support the findings of previous studies indicating that cell adhesion molecules of the CEA family may have a role in the development and progression of cutaneous melanoma and potentially serve as prognostic markers.
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Affiliation(s)
- Thilo Gambichler
- Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Sarah Grothe
- Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Sebastian Rotterdam
- Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Peter Altmeyer
- Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany
| | - Alexander Kreuter
- Department of Dermatology and Allergology, Ruhr-University Bochum, Bochum, Germany
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26
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Nonaka D, Chiriboga L, Rubin BP. Differential expression of S100 protein subtypes in malignant melanoma, and benign and malignant peripheral nerve sheath tumors. J Cutan Pathol 2008; 35:1014-9. [PMID: 18547346 DOI: 10.1111/j.1600-0560.2007.00953.x] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
BACKGROUND Desmoplastic melanoma (DM) may simulate various benign and malignant lesions, including benign peripheral nerve sheath tumors (BPNSTs) and malignant peripheral nerve sheath tumors (MPNSTs). The latter case is diagnostically challenging because DM generally show only S100 protein expression but no reaction to melanocytic markers. S100 family of proteins consists of over 20 members. We report on S100 subtypes in malignant melanomas (MMs), and BPNSTs and MPNSTs to investigate differential expression. DESIGN S100A1, S100A2, S100A4, S100A6 and S100B immunostains were performed on 80 MMs including conventional and desmoplastic types, 86 BPNSTs and 77 MPNSTs. RESULTS S100A1 expression was seen in > 91% of MMs in a diffuse reaction, whereas BPNSTs showed focal or no reaction. Sixteen percent of MPNSTs focally expressed S100A1 except for one case with diffuse reaction. S100A2 staining was negative or focal in all three groups whereas S100A4 reaction was variable in all three. S100A6 was diffusely expressed in MMs, BPNSTs and MPNSTs. S100B was stained diffusely in MMs and BPNSTs, but its reaction was observed in 30% of MPNSTs in a focal fashion. CONCLUSION S100A1 expression was diffuse in most of MMs but absent or focal in BPNSTs and MPNSTs. This may be helpful to distinguish between the two entities.
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Affiliation(s)
- Daisuke Nonaka
- Department of Pathology, New York University School of Medicine, New York, NY 10016, USA.
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27
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Puri PK, Forman SB, Ferringer T, Elston D. S100 A6 immunohistochemical staining for spindle cell and desmoplastic melanomas. J Cutan Pathol 2008; 35:256-7. [PMID: 18190457 DOI: 10.1111/j.1600-0560.2007.00788.x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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28
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Fernandes BF, Odashiro AN, Saraiva VS, Logan P, Antecka E, Burnier MN. Immunohistochemical expression of melan-A and tyrosinase in uveal melanoma. J Carcinog 2007; 6:6. [PMID: 17445277 PMCID: PMC1864985 DOI: 10.1186/1477-3163-6-6] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2007] [Accepted: 04/20/2007] [Indexed: 11/23/2022] Open
Abstract
Background Melan-A and tyrosinase are new immunohistochemical markers that can be used in the diagnosis of melanocytic lesions. The aim of this study was to investigate the correlation between radiotherapy or clinicohistopathological parameters and the expression of melan-A and tyrosinase in uveal melanoma. Methods Thirty-six enucleated cases of uveal melanoma were studied. The formalin-fixed, paraffin-embedded specimens were immunostained with monoclonal antibodies against melan-A and tyrosinase. The samples were classified as either positive or negative. The chi-square or the Student-t tests were used to test for the correlation of the expression rates of melan-A and tyrosinase with clinico-pathological parameters. Results Melan-A and tyrosinase were positive in 33 (91.7%) and 35 (97.2%) of the specimens, respectively. There was no significant association between the expression of melan-A or tyrosinase and radiotherapy or any clinico-pathological parameter. All specimens were positive for at least one of the immunohistochemical markers. Conclusion To the best of our knowledge this is the first study concluding that the expression of melanocytic markers such as melan-A and tyrosinase is not influenced by radiotherapy or any clinico-pathological parameter. Moreover, when tyrosinase and melan-A are used together, 100% of the formalin-fixed, paraffin-embedded uveal melanoma samples tested positive for one of those markers.
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Affiliation(s)
- Bruno F Fernandes
- Department of Ophthalmology and Pathology, The McGill University Health Center & Henry C, Witelson Ocular Pathology Laboratory, Montreal, Canada
- Department of Ophthalmology, Federal University of São Paulo, UNIFESP/EPM, São Paulo, Brazil
| | - Alexandre N Odashiro
- Department of Ophthalmology and Pathology, The McGill University Health Center & Henry C, Witelson Ocular Pathology Laboratory, Montreal, Canada
| | - Vinicius S Saraiva
- Department of Ophthalmology and Pathology, The McGill University Health Center & Henry C, Witelson Ocular Pathology Laboratory, Montreal, Canada
| | - Patrick Logan
- Department of Ophthalmology and Pathology, The McGill University Health Center & Henry C, Witelson Ocular Pathology Laboratory, Montreal, Canada
| | - Emilia Antecka
- Department of Ophthalmology and Pathology, The McGill University Health Center & Henry C, Witelson Ocular Pathology Laboratory, Montreal, Canada
| | - Miguel N Burnier
- Department of Ophthalmology and Pathology, The McGill University Health Center & Henry C, Witelson Ocular Pathology Laboratory, Montreal, Canada
- Department of Ophthalmology, Federal University of São Paulo, UNIFESP/EPM, São Paulo, Brazil
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