Aberrant neurofilament protein and synaptophysin expression in malignant melanoma of the nasal cavity

Coli, Antonella; Giacomini, P; Bigotti, Giulio; Ferraro, Silvia; Alessandrini, Marco; Vecchio, Michele Del; Massi, Guido

doi:10.1111/j.1365-2559.2004.01784.x

Cited by 19 publications

(28 citation statements)

References 13 publications

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“…Published reports documented a variable degree of labeling with S-100 in SNM, ranging from 86% to 100%. 2,11,[15][16][17] However, in our study, all 5 cases showed negative or focal scattered staining for S-100. The small cells were almost negative for S-100 although pleomorphic cells in the same tumor with mixed pattern gave strong positive reactions.…”

Section: Discussioncontrasting

confidence: 58%

“…8,14 About 80% of SNM arise in the nasal cavity with septum and inferior turbinate being the most commonly involved sites. 3,7,11 It is rare in the middle turbinate, and there are no case reports of SNM from the superior turbinate or olfactory recess. 3 In general, frequent local recurrences after surgical resection and distant metastases of SNM portend a grave prognosis.…”

Section: Discussionmentioning

confidence: 96%

“…8,11,16,19 In their immunohistochemical study of 17 mucosal melanoma cases, Yu et al 20 suggested that HMB-45 is a more sensitive marker than S-100 or Melan-A in primary oral and nasal mucosal melanoma. HMB-45 and Melan-A stain were 2+ or 3+ positive with variable intensity except in one case of small cell pattern (case 2) in our series.…”

Section: Discussionmentioning

confidence: 98%

“…10 Also nasal mucosal melanoma expressing both neurofilament protein (NFP) and synaptophysin without histologic evidence of neuronal differentiation has been documented. 11 Eyden et al 12 recently described 2 cases of cutaneous malignant melanoma and a case of nasal mucosal melanoma coexpressing synaptophysin, chromogranin, and NFP either in the primary tumor or in lymph node metastasis. They confirmed the presence of cytoplasmic neuroendocrine granules by ultrastructural examination, proposing the term "malignant melanoma with neuroendocrine differentiation" for this rare subset of melanoma.…”

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confidence: 98%

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Immunophenotypic Heterogeneity of Primary Sinonasal Melanoma With Aberrant Expression of Neuroendocrine Markers and Calponin

Lee

Torres

McLean³

et al. 2011

Applied Immunohistochemistry &Amp; Molecular Morphology

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Primary sinonasal melanoma is an aggressive tumor that often presents a diagnostic challenge owing to its rarity and variable morphology. Unusual immunophenotypic expression of sinonasal melanoma compounds the problem particularly in a limited tissue sample. We studied immunohistochemical patterns of 5 primary sinonasal melanoma using antibodies against pan-cytokeratin, S-100, HMB-45, Melan-A, chromogranin, synaptophysin, neurofilament protein, and calponin and correlated these patterns with histologic appearance. Sinus/nasal mucosa from non-neoplastic cases were stained for Melan-A to evaluate prevalence of melanocytes in the benign mucosa in comparison to the staining pattern of the mucosa adjacent to the tumor. Similar to previous report, small cell pattern appeared to be over represented in the sinonasal melanoma. Small cell population in 4 cases was almost devoid of pigment, and also was either completely negative or only focally positive for S-100. Three cases stained positive for neuroendocrine markers and neurofilament protein bringing olfactory neuroblastoma and small cell neuroendocrine carcinoma in as differential diagnosis. Three cases were focally positive for calponin without spindle cell morphology or desmoplastic reaction. Immunophenotypic heterogeneity along with the unconventional histomorphology of sinonasal melanoma compounds diagnostic problem and warrants a precautionary approach to avoid misinterpretation. It is necessary to apply a broad panel of immunohistochemistry for the purpose of screening when sinonasal melanoma is considered as a differential diagnosis.

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Section: Discussioncontrasting

confidence: 58%

Section: Discussionmentioning

confidence: 96%

Section: Discussionmentioning

confidence: 98%

mentioning

confidence: 98%

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Immunophenotypic Heterogeneity of Primary Sinonasal Melanoma With Aberrant Expression of Neuroendocrine Markers and Calponin

Lee

Torres

McLean³

et al. 2011

Applied Immunohistochemistry &Amp; Molecular Morphology

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“…5 It is less widely appreciated that melanomas too may show aberrant expression of various immunohistochemical markers, with a relatively small number of reports, of melanomas showing expression of intermediate filaments other than vimentin (e.g., keratins, desmin, neurofilament protein, and glial fibrillary acidic protein) [6][7][8] and/or neuroendocrine markers. [9][10][11] Over the past several years, we have seen in consultation a significant number of melanomas in which aberrant expression of intermediate filaments and/or neuroendocrine markers obscured the correct diagnosis, and prompted consideration of various non-melanocytic neoplasms, including carcinoma, rhabdomyosarcoma, neural neoplasms, and various neuroendocrine tumors. As no study to date appears to have comprehensively examined this issue, we evaluated a large number of well-characterized melanomas, using contemporary immunohistochemical techniques, to better determine the actual frequency of aberrant expression of these markers.…”

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confidence: 99%

Aberrant intermediate filament and synaptophysin expression is a frequent event in malignant melanoma: an immunohistochemical study of 73 cases

2015

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Malignant melanomas are known to express vimentin, among other intermediate filaments. Though anomalous keratin expression by malignant melanoma has been reported, its frequency is not well-established and this phenomenon is not well-known. We have seen in consultation a number of malignant melanomas with anomalous expression of keratin, other intermediate filaments, or synaptophysin, and therefore studied a large group of primary and metastatic melanomas to determine the frequency of these events. About 73 cases of malignant melanoma (22 primaries and 51 metastases) from 71 patients (51 male, 20 female; mean 59 years, range 17-87 years) were retrieved from our archives. Prior diagnoses were confirmed by re-review of hematoxylin and eosin sections and relevant (e.g., S100 protein, HMB45, Melan-A, and tyrosinase) immunohistochemical studies. Available sections were immunostained for keratin (OSCAR and AE1/AE3 antibodies), desmin, neurofilament protein, glial fibrillary acidic protein, synaptophysin, and chromogranin A. Not all cases could be tested for all markers. Cases were predominantly epithelioid (48/73, 66%) or spindle cell/desmoplastic (25/73, 34%). S100 protein, Melan-A, HMB45, and tyrosinase were positive in 60/65 (92%), 34/64 (53%), 30/60 (50%), 25/48 (52%) of cases, respectively. All five S100-protein-negative cases expressed at least one of the other melanocytic markers: Melan-A (two of four, 50%), HMB45 (two of three, 67%), and tyrosinase (one of two, 50%). All cases expressed at least one melanocytic marker. Cases were positive for keratin (OSCAR, 17/61, 28%; AE1/AE3, 16/40, 40%), desmin (11/47, 24%), neurofilament protein (5/31, 16%), glial fibrillary acidic protein (3/32, 9%), and synaptophysin (10/34, 29%), typically only in a minority of cells. Chromogranin was negative (0/32, 0%).

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Mimickers of neuroendocrine tumors on endoscopic ultrasound‐guided fine‐needle aspirate material: Need for caution

Wang

Lee

Mani

2023

Diagnostic Cytopathology

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Cytologic diagnosis of neuroendocrine tumors can be straightforward on cytologic preparations, given the classical neuroendocrine morphology and expression of neuroendocrine markers confirmed by immunohistochemistry. However, overreliance on neuroendocrine markers can lead to misdiagnosis even if individual cell features suggest a neuroendocrine tumor. We present three unusual cases, two of which were initially diagnosed as neuroendocrine tumors and the third one carried preliminary diagnosis of neuroendocrine tumor on endoscopic ultrasound‐guided fine‐needle aspirates. These cases subsequently turned out to be cholangioblastic cholangiocarcinoma, metastatic melanoma, and gastric glomus tumor, respectively. We suggest approaches that could have pointed us towards the correct diagnosis at the outset and discuss potential pitfalls.

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Aberrant neurofilament protein and synaptophysin expression in malignant melanoma of the nasal cavity

Cited by 19 publications

References 13 publications

Immunophenotypic Heterogeneity of Primary Sinonasal Melanoma With Aberrant Expression of Neuroendocrine Markers and Calponin

Immunophenotypic Heterogeneity of Primary Sinonasal Melanoma With Aberrant Expression of Neuroendocrine Markers and Calponin

Aberrant intermediate filament and synaptophysin expression is a frequent event in malignant melanoma: an immunohistochemical study of 73 cases

Mimickers of neuroendocrine tumors on endoscopic ultrasound‐guided fine‐needle aspirate material: Need for caution

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