Melanocytic pseudotumors

Česká verzia

Authors: L. Pock
Authors place of work: Dermatohistopatologická laboratoř, Praha
Published in the journal: Čes.-slov. Patol., 48, 2012, No. 3, p. 127-134
Category: Přehledový článek

Summary

Melanocytic lesions are one of the most difficult chapters of dermatopathology when you consider the number of entities, high frequency of excisions and serious consequences of a mistaken diagnosis. Melanocytic pseudotumours, benign lesions simulating melanoma, are its subgroup. At present, it is possible to designate 25 entities and situations. Spitzoid, combined, spindle cell and hyperpigmented lesions belong to the most common problems in the differential diagnosis. Not only histological but also clinical – dynamical and morphological – criteria ought to be taken into account for the maximally correct diagnosis. In heterogeneous lesions it is necessary, although difficult, to try to find the individual components of the lesion in sections. For this reason it is important to know the macroscopy of a particular lesion. In cases where it is impossible to make a reliable decision between benignity and malignancy it is necessary to choose the optimal therapeutic approach in collaboration with a clinical physician.

Keywords:
melanoma simulators – histology - borderline melanocytic lesions – diagnostic approach

Zdroje

1. Ackley CD, Prieto VG, Bentley RC, Horenstein MG, Seigler HF, Shea CR. Primary chondroid melanoma. J Cutan Pathol 2001; 28: 482–485.

2. Jih DM, Morgan MB, Bass J, Tuthill R, Somach S. Oncocytic metaplasia occuring in a spectrum of melanocytic nevi. Am J Dermatopathol 2002; 24(6): 468–472.

3. Lodha S, Saggar S, Celebi JT, Sivers DN. Discordance in the diagnosis of difficult melanocytic neoplasm in the clinical settings. J Cutan Pathol 2008; 35(4): 349–352.

4. Barnhill RL, Argenyi ZB, From L, et al. Atypical Spitz nevi/tumors: lack of consensus for diagnosis, discrimination from melanoma, and prediction of outcome. Hum Pathol 1999; 30: 513–520.

5. Coskey RJ, Mehregan A. Spindle cell nevi in adults and children. Arch Dermatol 1973; 108: 535–536.

6. Requena C, Requena L, Kutzner H, et al. Spitz nevus: a clinicopathological study of 349 cases. Am J Dermatopathol 2009; 31: 107–116.

7. Luo S, Sepehr A, Tsao H. Spitz nevi and other Spitzoid lesions. Part I. Background and diagnoses. J Am Acad Dermatol 2011; 65: 1073–1084.

8. Luzur B, Bastian BC, Calonje E. Melanocytic nevi. In: Calonje E, Brenn T, Lazar A, McKee PH, eds. McKee’s Pathology of the skin with clinical correlations (4^th ed). China, Elsevier Saunders; 2012: 1151–1220.

9. Lazzaro B, Reebers A, Herlyn M, et al. Immunophenotyping of compound and Spitz nevi and vertical growth phase melanomas using a panel of monoclonal antibodies reactive in paraffin sections. J Invest Dermatol 1993; 100: 313–317.

10. Bergman R, Azzam H, Sprecher E, et al. A comparative immunohistochemical study of MART-1 expression in Spitz nevi, ordinary melanocytic nevi, and malignant melanomas. J Am Acad Dermatol 2000; 42: 496–500.

11. Choi JH, Sung KJ, Koh JK. Pigmented epithelioid cell nevus: a variant of Spitz nevus?. J Am Acad Dermatol 1993; 28: 497–498.

12. LeBoit P. Spitz nevus: a look back and a look ahead. Adv Dermatol 2000; 10:81–108.

13. Ko CJ, McNiff M, Glusac J. Melanocytic nevi with features of Spitz nevi and Clark’s/dysplastic nevi („Spark’s nevi“). J Cutan Pathol 2009; 36: 1063–1068.

14. Ludgate MW, Fullen DR, Lee J, et al. The atypical Spitz tumor of uncertain biologic potential: a series of 67 patients from a single institution. Cancer 2009; 115: 631–641.

15. Tom WL, Hsu JW, Eichenfield LF, Fallon Friedlander S. Pediatric “STUMP“ lesions: Evaluation and management of difficult atypical Spitzoid lesions in children. J Am Acad Dermatol 2011; 64: 559–572.

16. Ball NJ, Golitz LE. Melanocytic nevi with focal atypical epithelioid cell components: A review of seventy-three cases. J Am Acad Dermatol 1994; 30 (5): 724–729.

17. High WA, Alanen KW, Golitz LE. Is melanocytic nevus with focal atypical epithelioid components (clonal nevus) a superficial variant of deep penetrating nevus? J Am Acad Dermatol 2006; 55(3): 460–466.

18. Kiyohara T, Sawai T, Kumakiri M. Proliferative nodule in small congenital melanocytic naevus after childhood. Acta Derm Venereol 2011; 92 (1): 96–97.

19. Xu X, Belluci KSW, Elenitsas R, Elder DE. Cellular nodules in congenital pattern nevi. J Cutan Pathol 2004; 31: 153–159.

20. Grunwald MH, Gat A, Amichai B. Pseudomelanoma after Solcoderm treatment. Melanoma Res 2006; 16: 459–460.

21. Reed RJ. The histological variance of malignant melanoma: the interrelationship of histological subtype, neoplastic progression and biological behavior. Pathology 1985; 17: 301–312.

22. Sherill AM, Crespo G, Prakash AV, Messina JL. Desmoplastic nevus: An entity distinct from Spitz nevus and blue nevus. Am J Dermatopathol 2011; 33: 35–39.

23. Kucher C, Zhang PJ, Pasha T, et al. Expression of Melan-A and Ki-67 in desmoplastic melanoma and desmoplatic nevi. Am J Dermatopathol 2004; 26: 452–457.

24. Harris GR, Shea CR, Horenstein MG, Reed JA, Burchette Jr. JL, Prieto VG. Desmoplastic (sclerotic) nevus. An underrecognized entity that resembles dermatofibroma and desmoplastic melanoma. Am J Surg Pathol 1999; 23(7): 786–794.

25. Zembowicz A, Granter SR, McKee PH,Mihm MC. Amelanotic cellular blue nevus. A hypopigmnted variant of the cellular blue nevus: clinicopathologic analysis of 20 cases. Am J Dermatopathol 2002; 26(11): 1493–1500.

26. Kanneishi NK, Cockerell CJ. Histologic differentiation of desmoplastic melanoma from cicatrices. Am J Dermatopathol 1998; 20(2): 128–134.

27. Groben PA, Harvell JD, White WL. Epithelioid blue nevus. Neoplasm sui generis or variation on a theme? Am J Dermatopathol 2000; 22(6): 473–488.

28. Zembowicz A, Carney JA, Mihm MC. Pigmented epithelioid melanocytoma A low grade melanocytic tumor with metastatic potential indistinguishable from animal-type melanoma and epitelioid blue nevus. Am J Surg Pathol 2004; 28: 31–40.

29. Flax SH, Skelton HG, Smith KJ, Lupton GP. Nodular melanosis due to epithelial neoplasm. Am J Dermatopathol 1998; 20(2): 118–122.

30. Orchard GE, Calonje E. The effect of melanin bleaching on immunochistochemical staining in heavily pigmented melanocytic neoplasm. Am J Dermatopathol 1998; 20(4): 357–361.

31. Ward JR, Brady SP, Tada H, Levin NA. Pigmented epithelioid melanocytoma. Int J Derm 2006; 45: 1403–1405.

32. Elder DE, Xu X. The approach to the patient with difficult melanocytic lesion. Pathology 2004; 36: 428–434.

33. Cerroni L, Barnhill R, Elder D, et al. Melanocytic tumors of uncertain malignat potential. Results of a tutorial held at the XXIX Symposium of the International Society of Dermatopathology in Graz, October 2008. Am J Surg Pathol 2010; 34: 314–326.

34. Luo S, Sepehr A, Tsao H. Spitz nevi and other Spitzoid lesions. Part II. Natural history and management. J Am Acad Dermatol 2011; 65: 1087–1092.

35. Pock L, Fikrle T, Drlík L, Zloský P. Dermatoskopický atlas (2. vyd.). Phlebomedica: Praha: 2008.

36. Bolognia J, Lin A, Shapiro PE. The significance of eccentric foci of hyperpigmentation (small dark dots) within melanocytic nevi. Arch Dermatol 1994; 130: 1013–1017.

37. Cerroni L. The illusion of certainty. Dermatopathol Practical Conceptual 2000; 6: 87–92.