Bednár tumor associated with dermal melanocytosis: melanocytic colonization or neuroectodermal multidirectional differentiation?

Goncharuk, Viktor N.; Mulvaney, Michael J.

doi:10.1034/j.1600-0560.2003.00030.x

Cited by 40 publications

(30 citation statements)

References 45 publications

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“…30,34 More recent report indicated that dermatofibrosarcoma protuberans is probably a neuromesenchymal neoplasm based on the observations in Bednar tumors. 31 In our study, D2-40 was positive in all dermatofibromas, including cellular fibrous histiocytoma. In contrast, none of the dermatofibrosarcoma protuberans was labeled, although four cases showed a patchy and faint background staining.…”

Section: Resultsmentioning

confidence: 79%

“…[22][23][24][25][26][27] Schacht et al 27 also demonstrated the expression of D2-40 in some other nonendothelial cells beyond the above-mentioned cells To date, there are controversies and uncertainties regarding the histiogenesis of dermatofibromas and dermatofibrosarcoma protuberans. [28][29][30][31] For dermatofibroma, various cells of origin, including fibroblast, histiocyte, and endothelial cell, have been hypothesized. Some authors suggested myofibroblastic derivative for cellular fibrous histiocytoma given its reactivity for a1-smooth muscle actin.…”

Section: Resultsmentioning

confidence: 99%

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D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans

Bandarchi

Marginean

et al. 2010

Modern Pathology

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The distinction between dermatofibroma, particularly cellular variant, and dermatofibrosarcoma protuberans in excisional biopsies is usually straightforward. However, a separation between the two may be sometimes challenging, especially in superficial biopsies. Although factor XIIIa and CD34 immunostains are useful in differentiating dermatofibroma and dermatofibrosarcoma protuberans in most instances, focal CD34 positivity may be seen in cellular fibrous histiocytoma. Some cases reveal overlapping immunostain results. D2-40 identifies a 40-kDa O-linked sialoglycoprotein present on a variety of tissues including testicular germ cell tumors as well as lymphatic endothelium. In this study, we investigated the utility of D2-40 in separating dermatofibroma from dermatofibrosarcoma protuberans and compared the results with other commonly used immunostains. Fifty-six cases of dermatofibroma (including six cellular variant) and 29 cases of dermatofibrosarcoma protuberans were retrieved from the archives of Department of Anatomic Pathology at Sunnybrook Health Sciences Center in University of Toronto. We applied factor XIIIa, CD34, and monoclonal mouse anti-D2-40 immunostains to formalin-fixed, paraffin-embedded tissue sections. All 56 (100%) cases of dermatofibroma demonstrated strong and diffuse immunoreactivity to D2-40 in the spindle cells and stroma. Similarly, factor XIIIa showed strong and diffuse positivity in the spindle cells. Nearly all dermatofibromas were negative for CD34 except one case revealing focal positivity. None of dermatofibrosarcoma protuberans cases were labeled by D2-40, although four cases showed weak and patchy background staining in contrary to diffuse, strong, and crisp staining seen in dermatofibromas. Our results indicate that D2-40 seems to be a sensitive immunohistochemical marker for dermatofibromas, including cellular variant. Focal and faint D2-40 staining may be seen in the stroma of dermatofibrosarcoma protuberans. Our findings suggest that D2-40 can be used as a complementary immunostain to factor XIIIa and CD34 in problematic and challenging cases on superficial biopsies.

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Section: Resultsmentioning

confidence: 79%

Section: Resultsmentioning

confidence: 99%

D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans

Bandarchi

Marginean

et al. 2010

Modern Pathology

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“…197 The Bednar tumor has also been shown to express a mixed immunophenotype (CD34-or Mart-1-positive) in dispersed dermal spindle cells within a DFSP-like lesion suggesting a common cell of origin, namely, a putative neuromesenchymal cell, the potential cell of origin of all neural crest-derived dermal tumors including DFSP. 198 This overlap of histologic and immunohistochemical phenotypes may indicate the existence of a spectrum of neuromesenchymal conditions that range from purely melanocytic lesions (dermal melanocytosis and blue nevi), to varied proportions of melanocytic and neuromesenchymal elements (cellular blue nevi, desmoplastic melanomas, and Bednar tumors), to purely mesenchymal lesions (DFSP).…”

Section: Cd34 Expression In Malignant Melanomamentioning

confidence: 99%

Unusual variants of malignant melanoma

2006

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A potential diagnostic pitfall in the histologic assessment of melanoma is the inability to recognize unusual melanoma variants. Of these, the more treacherous examples include the desmoplastic melanoma, the nevoid melanoma, the so-called 'minimal-deviation melanoma,' melanoma with prominent pigment synthesis or 'animal-type melanoma,' and the malignant blue nevus. Also problematic are the unusual phenotypic profiles seen in vertical growth phase melanomas; these include those tumors whose morphological peculiarities mimic cancers of nonmelanocytic lineage and those melanomas that express aberrant antigenic profiles not commonly associated with a melanocytic histogenesis. Metaplastic change in melanoma, balloon cell melanoma, signet-ring cell melanoma, myxoid melanoma, small cell melanoma and rhabdoid melanoma all have the potential to mimic metastatic and primary neoplasms of different lineage derivations. Abnormal immunohistochemical expression of CD 34, cytokeratins, epithelial membrane antigen, and smooth muscle markers as well as the deficient expression of S100 protein and melanocyte lineage-specific markers such as GP100 protein (ie HMB-45 antibody) and A103 (ie Melan-A) also present confusing diagnostic challenges. In this review, we will discuss in some detail certain of these novel clinicopathologic types of melanoma, as well as the abnormal phenotypic expressions seen in vertical growth phase melanoma. Modern Pathology (2006) 19, S41-S70. doi:10.1038/modpathol.3800516Keywords: melanoma; variants; phenotype; immunohistochemistry; morphology Desmoplastic melanoma Introduction and Clinical FeaturesDemoplastic melanoma is a rare variant of malignant melanoma first recognized in 1971.1 Desmoplastic and neurotropic melanoma may be mistaken clinically for a scar, a fibroma, a basal cell carcinoma, or a fibromatosis. Sometimes there is pronounced mucin deposition that imparts a boggy quality to the lesion. 2,3 The clinical clue to the diagnosis, when present, is cutaneous or mucosal pigmentation overlying a palpable dermal or submucosal nodule. That said, only half of desmoplastic melanomas are clinically pigmented. 3 Desmoplastic melanomas tend to occur in the head and neck area and the upper back [4][5][6][7] but are also seen in mucosal sites such as the vulva or gingiva 8 and in acral locations. Typically, they occur in older patients, with mean ages in the larger series falling into the sixth to eighth decades of life. 4,6,[9][10][11][12][13][14][15] Larger series show a male preponderance of 1.75 to 1. 15 Although any given desmoplastic melanoma can be deeply invasive, when matched for depth of invasion, they are associated with a lesser risk of metastatic disease than conventional melanomas of similar depth. The classical clinical finding is that of a pale or fleshy firm nodule reminiscent of a scar, which tends to delay clinical diagnosis and biopsy. Carlson et al,6 who reported an equal distribution in men and women, found most tumors to be located in the head and neck area (75%) and to be nonpigment...

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“…. It is seen in young to middle-aged adults in the fourth decade with very occasional cases in the pediatric age group [6,7] . The most common site of the bednar tumor is trunk and proximal extremities [8,9,10] .…”

Section: Discussionmentioning

confidence: 99%

Bednar tumor or Pigmented Variant of Dermatofibrosarcoma protuberans: A Rare Case Report

Banerjee¹,

Mridha²,

Shrivastava³

et al. 2017

IOSR JDMS

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Bednár tumor associated with dermal melanocytosis: melanocytic colonization or neuroectodermal multidirectional differentiation?

Cited by 40 publications

References 45 publications

D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans

D2-40, a novel immunohistochemical marker in differentiating dermatofibroma from dermatofibrosarcoma protuberans

Unusual variants of malignant melanoma

Bednar tumor or Pigmented Variant of Dermatofibrosarcoma protuberans: A Rare Case Report

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