Spitz nevi in the classic histopathological pattern - lamb in wolf`s clothing

Verardino, Gustavo Costa; Rochael, Mayra Carrijo

doi:10.1590/abd1806-4841.20153310

Cited by 11 publications

(13 citation statements)

References 15 publications

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“…Our findings underline that spitzoid melanocytic lesions represent highly immunogenic neoplasms with 67.1% (53 of 79) of cases corresponding to an IP2 or IP3 score. Our data confirm observations from other groups that reported an inflammatory infiltrate to be present in 61%, 26 69%, 2 51%, 3 73%, 5 70% 1 and 23% 35 and in 75% 34 of their studied cases (for overview see also Table 2). Berlingeri‐Ramos et al .…”

Section: Discussionsupporting

confidence: 92%

“…Although inflammation is frequently observed in spitzoid melanocytic neoplasms, 1,2,34–36 a more detailed characterisation and analysis of the distribution, composition and immunophenotypical characteristics of the inflammatory cells has only marginally been considered in previous series. Thus, the aim of this study was to more clearly characterise the inflammatory microenvironment in spitzoid melanocytic neoplasms.…”

Section: Discussionmentioning

confidence: 99%

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Integrative histopathological and immunophenotypical characterisation of the inflammatory microenvironment in spitzoid melanocytic neoplasms

et al. 2020

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Aims The role of inflammation in conventional cutaneous melanoma has been extensively studied, whereas only little is known about the inflammatory microenvironment and immunogenic properties of spitzoid melanocytic neoplasms. The composition of infiltrating immune cells and the architectural distribution of the inflammation, in particular, are still obscure. This is the first study, to our knowledge, to systematically characterise the inflammatory patterns and the leucocyte subsets in spitzoid melanocytic lesions. Methods and results We examined 79 spitzoid neoplasms including banal Spitz naevi (SN, n = 50), atypical Spitz tumours (AST, n = 17) and malignant Spitz tumours (MST, n = 12) using histopathological analysis and immunohistochemistry. Spitzoid melanocytic lesions showed a high frequency (67.1%, n = 53 of 79) of inflammation. Four inflammatory patterns were identified according to architectural composition, distribution and intensity of inflammation. The majority of the inflammatory infiltrate corresponded to CD3+/CD8+ T lymphocytes (56.1%), followed by CD3+/CD4+ T cells (35.7%) and CD68+ histiocytes (20.3%). CD3+/TIA‐1+ cytotoxic T lymphocytes constituted 3.7% of inflammatory cells. Rarely, CD3+/ granzyme B+ cytotoxic T lymphocytes (2.7%) and CD138+ plasma cells (0.5%) were detected in the infiltrating immune cells. There was no significant difference in the inflammatory cellular composition among the spitzoid melanocytic subgroups (SN versus AST versus MST). Conclusion Our findings demonstrate that Spitz tumours are highly immunogenic lesions. Inflammation with the presence of lymphocytic aggregates predominated in SN, but was not distinctive for this melanocytic category. A strong and intense inflammation was suggestive of an underlying malignancy. The infiltrating cytotoxic T lymphocyte subsets in Spitz tumours deserve further investigation in larger study cohorts to elucidate prognostic and immuno‐oncological therapeutic relevance.

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Section: Discussionsupporting

confidence: 92%

Section: Discussionmentioning

confidence: 99%

Integrative histopathological and immunophenotypical characterisation of the inflammatory microenvironment in spitzoid melanocytic neoplasms

et al. 2020

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“…Peran p15 ini akan hilang pada melanoma maligna. 32,33 Terdapat empat tipe histopatologi melanoma maligna pada penelitian ini yaitu mucosal melanoma, nodular melanoma, akral melanoma dan conjunctival melanoma. Semua spesimen melanoma maligna pada penelitian ini memiliki ekspresi p15 rendah.…”

Section: Pembahasanunclassified

Hubungan Tingkat Ekspresi P15 Terhadap Nevus Melanositik Dan Melanoma Maligna

Nasution

Kartika

Theodorus

2021

JKK

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Latar Belakang. Lesi melanositik memiliki gambaran morfologi dan sitomorfologi yang luas mencakup lesi jinak yaitu nevus melanositik dan lesi ganas yaitu melanoma maligna. Beberapa gambaran nevus melanositik menyerupai melanoma. p15 merupakan gen penekan tumor dan biomarker yang kuat sehingga dapat digunakan untuk membedakan antara nevus dan melanoma. Tujuan. Mengetahui hubungan tingkat ekspresi p15 pada nevus dan melanoma. Metodologi. Penelitian ini merupakan penelitian deskriptif observasional dengan desain serial kasus sejak 1 Januari 2015 sampai 30 Desember 2019. Sebanyak 60 sampel dilakukan pemeriksaan imunohistokimia menggunakan antibodi p15. Ekspresi p15 dinilai berdasarkan proporsi sel tumor yang terpulas dan intensitas pulasan. Analisis statistik menggunakan SPSS versi 23.0. Hasil. Nevus melanositik paling banyak dijumpai pada perempuan (76,7%), pada kelompok usia <55 tahun (90%), lokasi tumor pada kepala dan leher (83,3) dan pada tipe histopatologi dermal naevus (53,3%). Melanoma maligna paling banyak ditemukan pada jenis kelamin laki-laki (53,6%), pada kelompok usia <55 tahun (57,1%), lokasi tumor pada kepala dan leher (35,7%) dan pada tipe histopatologi nodular melanoma (42,9%). Terdapat hubungan bermakna antara tingkat ekspresi p15 dengan lesi melanositik (nevus melanositik dan melanoma maligna) (r=0,9666; p=0,000). Kesimpulan. Ekspresi p15 tinggi dijumpai pada nevus melanositik dan rendah pada melanoma maligna. Terdapat hubungan bermakna antara tingkat ekspresi p15 dengan lesi melanositik (nevus melanositik dan melanoma maligna). Semakin rendah ekspresi p15 maka semakin besar kemungkinan terjadi melanoma maligna.

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“…Secondly, Spitzoid melanocytic neoplasms are well-known to harbor prominent collagenous or fibrotic stroma with fine vascularization and presence of infiltrating lymphocytes (16, 18, 111–113). Despite these obvious histological characteristics only little is known about the underlying immunological cellular subtypes, especially the nature of the infiltrating T-lymphocytes and the dermal stromal microenvironment in Spitzoid melanocytic lesions (18, 114).…”

Section: Future Research Objectivesmentioning

confidence: 99%

Genomic Landscape of Spitzoid Neoplasms Impacting Patient Management

et al. 2018

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Spitzoid neoplasms are a distinct group of melanocytic proliferations characterized by epithelioid and/ or spindle shaped melanocytes. Intermediate forms that share features of both benign Spitz nevi (SN) and Spitz melanoma, i.e., malignant Spitz tumor (MST) represent a diagnostically and clinically challenging group of melanocytic lesions. A multitude of descriptive diagnostic terms exist for these ambiguous lesions with atypical Spitz tumor (AST) or Spitz tumor of uncertain malignant potential (STUMP) just naming two of them. This diagnostic gray zone creates confusion and high insecurity in clinicians and in patients. Biological behavior and clinical course of this intermediate group still remains largely unknown, often leading to difficulties with uncertainties in clinical management and prognosis. Consequently, a better stratification of Spitzoid neoplasms in benign and malignant forms is required thereby keeping the diagnostic group of AST/STUMP as small as possible. Ancillary diagnostic techniques such as immunohistochemistry, comparative genomic hybridization, fluorescence in situ hybridization, next generation sequencing, micro RNA and mRNA analysis as well as mass spectrometry imaging offer new opportunities for the distinct diagnosis, thereby allowing the best clinical management of Spitzoid neoplasms. This review gives an overview on these additional diagnostic techniques and the recent developments in the field of molecular genetic alterations in Spitzoid neoplasms. We also discuss how the recent findings might facilitate the diagnosis and stratification of atypical Spitzoid neoplasms and how these findings will impact the diagnostic work up as well as patient management. We suggest a stepwise implementation of ancillary diagnostic techniques thereby integrating immunohistochemistry and molecular pathology findings in the diagnosis of challenging ambiguous Spitzoid neoplasms. Finally, we will give an outlook on pending future research objectives in the field of Spitzoid melanocytic lesions.

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Spitz nevi in the classic histopathological pattern - lamb in wolf`s clothing

Cited by 11 publications

References 15 publications

Integrative histopathological and immunophenotypical characterisation of the inflammatory microenvironment in spitzoid melanocytic neoplasms

Integrative histopathological and immunophenotypical characterisation of the inflammatory microenvironment in spitzoid melanocytic neoplasms

Hubungan Tingkat Ekspresi P15 Terhadap Nevus Melanositik Dan Melanoma Maligna

Genomic Landscape of Spitzoid Neoplasms Impacting Patient Management

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