Nevoid malignant melanoma: morphologic patterns and immunohistochemical reactivity

McNutt, N. Scott; Urmacher, Carlos; Hakimian, J; Hoss, Diane M.; Lugo, J

doi:10.1111/j.1600-0560.1995.tb01146.x

Cited by 121 publications

(74 citation statements)

References 54 publications

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“…Immunohistochemical staining with Ki-67, [31][32][33][34] Ki-67 and bcl-2, 35 and proliferating cell nuclear antigen 36,37 has shown some promise in discrim-inating melanoma from benign nevi, including Spitz nevi. In situ hybridization to detect expression of melastatin, 38 a melanocyte specific gene that is expressed in melanoma at levels inversely proportional to metastatic rates, is useful in predicting metastasis and disease free survival in adult patients with melanoma 39 and may be useful in predicting which atypical spitzoid lesion may be malignant.…”

Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Fullen

Sondak

et al. 2003

Cancer

147

122

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A new device—the rotational particle separator (RPS)—is compared to the cyclone for the removal of ultrafine particles, such as cryogenically condensed contaminant droplets from natural gas. The comparison focusses on identifying for each configuration the smallest size of particle which has a 50% chance of being removed from the gas stream. Whereas a cyclone can only separate 1 μm droplets at very low‐throughputs on the order of 1 MMscfd, at the same energy consumption and device volume, the rotational particle separator removes droplets of that size at throughputs of 300 MMscfd. The advantage of the rotational particle separator, therefore, lies in its compact separation potential for full‐scale industrial gas well throughputs. © 2006 American Institute of Chemical Engineers AIChE J, 2007

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Section: Discussionmentioning

confidence: 99%

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Fullen

Sondak

et al. 2003

Cancer

147

122

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“…In particular, nevoid melanoma, [26][27][28][29][30][31][32][33] minimal deviation melanoma, 26,[34][35][36][37][38][39] desmoplastic melanoma, 33,[40][41][42][43][44][45] and the atypical spitzoid melanocytic proliferations 21,33 represent special problems in melanocytic tumor pathology.…”

Section: The Nature Of Error In Dermatopathological Practicementioning

confidence: 99%

Medicolegal aspects of neoplastic dermatology

Crowson

2006

Modern Pathology

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Medical malpractice litigation is rising at an explosive rate in the US and, to a lesser extent, in Canada. The impact of medical malpractice litigation on health care costs and the cost of insurance is dramatic. Certain specialist categories are becoming uninsurable in some parts of the US, while in others, clinicians are retiring early, restricting or changing practice or changing states of residence in consequence of medical malpractice claims and of the cost and availability of insurance. This, in turn, has had the real effect of denying care to patients in some communities in the US. Some 13% of all medical malpractice claims relate to one area of neoplastic dermatopathology, specifically, melanocytic neoplasia. Certain steps can be taken by pathology laboratories to reduce, but never completely eliminate, the risk of medical malpractice claims. In this review, attention is paid to the source of medical malpractice claims and an abbreviated approach to specific strategies for risk management is presented.

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“…The lesions manifest sharp lateral circumscription. 45,47 With respect to the intraepidermal component, prominent pagetoid infiltration is notably absent. Junctional activity is uncommon but can be observed in some cases of verrucoid forms of nevoid melanoma.…”

Section: Histologymentioning

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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Nevoid malignant melanoma: morphologic patterns and immunohistochemical reactivity

Cited by 121 publications

References 54 publications

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Sentinel lymph node biopsy for patients with problematic spitzoid melanocytic lesions

Medicolegal aspects of neoplastic dermatology

Unusual variants of malignant melanoma

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