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Mitoses in melanocytic lesions

Megan Anne Brown, Ben Tallon
Melanocytic nevi are submitted for histological evaluation primarily to exclude a malignant process. Mitotic figures are one of the factors used in this assessment. However, there is a lack of data on mitotic activity in juvenile benign nevi. The authors assessed 114 cases of benign melanocytic nevi in children aged 0-15 (inclusive) years old by counting the mitoses present in 2 sections of hematoxylin and eosin-stained tissue. The authors then calculated the proportion of cases in which mitotic activity was present, and the average number of mitoses per case for each age group to get the mitotic rate...
July 7, 2016: American Journal of Dermatopathology
J Fernando Val-Bernal, Marta Mayorga, Daniel Val
BACKGROUND: Benign melanocytic nevi (MN) of the anal canal are exceptional and require adequate differential diagnosis. There are no data on incidence of these lesions. Only a single case report of hemorrhoid with an MN has been reported. The necessity of routine pathologic evaluation of hemorrhoidectomy specimens has been questioned. MATERIAL AND METHODS: The authors undertook a retrospective histologic study of the hemorrhoidal tissue obtained in a series of 1918 consecutive hemorrhoidectomies performed between January 2004 and November 2012...
April 2016: American Journal of Dermatopathology
Dongsi Lu, Ethan C Levin, Louis P Dehner, Anne C Lind
Any mitotic activity in a melanocytic nevus is a source of concern about the biologic potential of that lesion, especially in an adult. Previously diagnosed benign melanocytic nevi in individuals from six different age groups were re-examined; mitotic figures were counted in routine hematoxylin and eosin stained sections; Ki-67 nuclear positivity was assessed by immunohistochemistry. Mitoses were seen in 0 to 14.3% of nevi in all groups of patients >1 year of age; 55.6% (5/9 cases) of nevi in patients <1-year old had mitoses identified histologically...
August 13, 2015: Journal of Cutaneous Pathology
Gustavo Costa Verardino, Mayra Carrijo Rochael
Spitz nevus is a benign melanocytic lesion and also one of the main differential diagnosis of melanoma. A descriptive and retrospective study of surgical specimens from patients with a diagnosis of Spitz nevus was conducted at two institutions in Niterói - RJ. 32 cases were analyzed. The most frequent histological subtype was compound (60 %), with a predominance of epithelioid cells (17 cases - 53%). Pagetoid spread was observed in 21 cases (68%). Maturation of melanocytes was present in 13 cases (81%). Kamino bodies were found in eight cases (25%)...
January 2015: Anais Brasileiros de Dermatologia
Oriol Yélamos, Nicoleta C Arva, Roxana Obregon, Pedram Yazdan, Annette Wagner, Joan Guitart, Pedram Gerami
Differentiating proliferative nodules (PNs) from melanomas arising in congenital nevi (CN) is a considerable challenge for dermatopathologists. Most of the specimens dermatopathologists assess that deal with this differential diagnosis involve proliferations of melanocytes arising in the dermis. In this study, we compare the clinical, histologic, and molecular findings of these 2 conditions. In our database, we found 22 examples of PNs arising in the dermis of CN and 2 cases of lethal melanomas arising from the dermis/epidermis of CN of children...
March 2015: American Journal of Surgical Pathology
Carla Antonella Pepe, Mara Lombardi, Chiara Cortelazzi, Francesca Aimi, Roberto Ricci, Maurizio Taglia, Silvia Santoro, Alfredo Zucchi, Fabio Zambito-Spadaro, Giuseppe De Panfilis, Giuseppe Fabrizi
BACKGROUND: Pigmented epitheliod melanocytoma (PEM) is a uncommon melanocytoma with unique histopathological features and possibly with a favourable prognosis, because, although sentinel lymph-node metastases may occur, in the great majority of cases described up to now there is no spread beyond regional lymph-nodes. The nature of PEM, its biologic behaviour and its relationships to naevi and melanoma, however, remain to be clearly established, and several Authors suggest that further cases of PEM with long follow-up should be published, in order to better assess the biologic/prognostic characteristics of PEM...
2014: Acta Bio-medica: Atenei Parmensis
Pranav Dorwal, Ishani Mohapatra, Dheeraj Gautam, Aditya Gupta
Melanocytomas are present in leptomeninges and arise from neural crest during early embryonic development. They are a rare entity and usually occur in the thoracic spine and infratentorial region. We report a 32-year-old female with meningeal melanocytoma of D9-10. Magnetic resonance imaging revealed an intramedullary spinal tumor at D9-D10. Intraoperatively, the tumor was greyish-black in color with moderate vascularity, and was adherent to the cord. The clinical differential diagnoses included cavernoma and melanocytoma...
January 2014: Asian Journal of Neurosurgery
F Boukari, C Butori, N Cardot-Leccia, S David, L Sillard, J-P Lacour
BACKGROUND: Histiocytoma (HC) is a very common benign tumour generally seen in the lower limbs of adults, particularly women. There are, however, atypical forms of HC that behave like locally aggressive tumours, occasionally with relapse or even metastasis. Herein we report a case of locally aggressive HC in a child, which, on account of its clinical extension, required seven surgical procedures to achieve complete excision. PATIENTS AND METHODS: A 13-year-old child consulted for a hard purplish papule measuring 8 mm in diameter located in the right lumbar region...
April 2014: Annales de Dermatologie et de Vénéréologie
Pedram Gerami, Klaus Busam, Alistair Cochran, Martin G Cook, Lyn M Duncan, David E Elder, Douglas R Fullen, Joan Guitart, Philip E LeBoit, Martin C Mihm, Victor G Prieto, Michael S Rabkin, Richard A Scolyer, Xiaowei Xu, Sook Jung Yun, Roxana Obregon, Pedram Yazdan, Chelsea Cooper, Bing Bing Weitner, Alfred Rademaker, Raymond L Barnhill
Predicting clinical behavior of atypical Spitz tumors remains problematic. In this study, we assessed interobserver agreement of diagnosis by 13 expert dermatopathologists for atypical Spitz tumors (n=75). We determined which histomorphologic features were most heavily weighted for their diagnostic significance by the experts and also which histomorphologic features had a statistically significant correlation with clinical outcome. There was a low interobserver agreement among the experts in categorizing lesions as malignant versus nonmalignant (κ=0...
July 2014: American Journal of Surgical Pathology
Leona A Doyle, Jason L Hornick, Christopher D M Fletcher
Perivascular epithelioid cell tumors (PEComas) are distinctive mesenchymal neoplasms that most often arise in the retroperitoneum, visceral organs, and abdominopelvic sites and usually show reactivity for melanocytic and smooth muscle markers. Fewer than 20 PEComas of the gastrointestinal (GI) tract have been reported, and behavior and criteria for malignancy are incompletely defined. The purpose of this study was to examine the clinicopathologic features of a series of GI PEComas and to evaluate prognostic parameters...
December 2013: American Journal of Surgical Pathology
Tao Wang, Harry Voogjarv, Rajkumar Vajpeyi
Perivascular epithelioid tumors (PEComa) are uncommon mesenchymal neoplasms demonstrating positivity for muscular and melanocytic immuno-markers. Included in this category are angiomyolipoma, lymphangioleiomyomatosis, and clear cell sugar tumors. Lesions which do not fit into these categories are classified as "not otherwise specified". We present a case of an incidentally discovered PEComa within inguinal hernia sac contents in a 70-year-old woman. It consisted of spindled and epithelioid cells with bland oval nuclei, small nucleoli and clear to light eosinophilic cytoplasm...
September 2013: Pathology, Research and Practice
Flavia Baderca, Iuliana Mateş, C Solovan
The blue nevus is a variant of a melanocytic nevus that presents as blue-gray to blue or black papules or nodules measuring up to 1 cm in diameter; it has a predilection for females and can be congenital or acquired. The classification of blue nevi is complex, with biological behavior being benign, borderline, or malignant. The case we present is one of a 40-year-old woman with multiple dermatofibromas that appeared and increased gradually in size during pregnancy. Physical examination revealed three spherical, brownish to red-purple nodules localized on the left leg, right shoulder and right laterocervical area...
2013: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Hai Wang, Shu Zhang, Chun Wu, Zhiyuan Zhang, Taichun Qin
BACKGROUND: Melanocytomas of the Central Nervous System (CNS) are rare and benign lesions. These slow-growing tumours can behave aggressively, with local recurrence. Various genetic aberrations occur in malignant melanomas and raise possible new therapeutic options. However, little information is available regarding these characteristic genetic alterations in melanocytomas of the CNS. This study was designed to better understand the clinicopathological and molecular features of melanocytomas...
August 2013: European Journal of Clinical Investigation
Adriana Diaconeasa, D Boda, C Solovan, D M Enescu, Alina Maria Vîlcea, Sabina Zurac
Spitz nevus is one of the most difficult melanocytic lesions to diagnose in regard of malignancy, even for experienced dermatopathologists. We analyzed 28 tumors with Spitzoid morphology from 15 children (three little children 2-4-year-old, 12 peripubertary children 9-17-year-old) and 13 adults; there were 21 Spitz nevi, five atypical Spitz tumors and two Spitzoid melanomas in order to establish the diagnostic value of several morphologic parameters in different age groups. No significant differences in respect of age and/or tumor type occurred for gender, location, dimension, symmetry, sharp lateral demarcation, junctional nests orientation, adipose tissue extension, side-to-side cytologic symmetry, uniform melanin deposits, nuclear pleomorphism, presence of mitoses, inflammation and epidermal alterations...
2013: Romanian Journal of Morphology and Embryology, Revue Roumaine de Morphologie et Embryologie
Thuy L T Nguyen, Amy Theos, David R Kelly, Klaus Busam, Aleodor A Andea
Proliferative (cellular) nodules (PN) which mimic malignant melanoma clinically and histologically are described in congenital melanocytic nevi (CMN) and may pose significant diagnostic challenges. We report the case of a 10-day-old male with a giant congenital nevus involving the neck, upper chest, back, and left shoulder containing several nodular lesions, some crusted. Biopsy of a nodule revealed densely packed nevus cells with hyperchromatic round to oval and occasionally irregularly shaped nuclei. There was no necrosis or pushing border, and the nodule blended with the adjacent nevus; however, the lesion demonstrated a significant number of mitoses (27 per mm2) and a 60% labeling index with Ki-67...
February 2013: American Journal of Dermatopathology
Emily A O'Rourke, Bonnie Balzer, Catherine I Barry, David P Frishberg
The presence of dermal mitotic figures is helpful in identifying malignant melanocytic lesions but occasionally occur in benign nevi. We aim to determine a "benchmark" mitotic frequency for a wide variety of nevi. We prospectively collected 1041 cases of benign melanocytic nevi and reviewed them for the presence of mitotic figures. Specimens were collected from female (62%) and male (38%) participants, ages ranged from 1 to 90 years. Nevus types included compound melanocytic nevi (CMN), intradermal melanocytic nevi, junctional melanocytic nevi, lentiginous CMN (LCMN), lentiginous junctional melanocytic nevi, blue nevi, deep penetrating nevi, and pigmented spindle cell nevi...
February 2013: American Journal of Dermatopathology
Namrata Setia, Ossama Abbas, Yessica Sousa, Jane L Garb, Meera Mahalingam
Distinct ABCB5 forms and ABCF2, members of the ATP-binding cassette (ABC) superfamily of transporters, are normally expressed in various tissues and cells, and enhanced expression of both has been demonstrated in select cancers. In melanoma cell lines, gene expression profiling of ABC transporters has revealed enhanced expression of melanocyte-specific ABCB5 and ABCF2 proteins. Given this, our primary aim was to ascertain immunohistochemical expression of the ABC transporters ABCB5 and ABCF2 and, the stem cell marker, nestin in a spectrum of benign and malignant nevomelanocytic proliferations, including nevi (n=30), in situ (n=31) and invasive (n=24) primary cutaneous melanomas to assess their role in the stepwise development of malignancy...
August 2012: Modern Pathology: An Official Journal of the United States and Canadian Academy of Pathology, Inc
Ronnie M Abraham, Michael E Ming, David E Elder, Xiaowei Xu
A subset of difficult melanocytic lesions exists with histopathologic features that evade diagnostic consensus from even expert dermatopathologists. Comparative genomic hybridization (CGH) has emerged as a useful diagnostic tool to categorize these lesions, by identifying known chromosomal aberrations in malignant melanoma or the lack thereof in melanocytic nevi. However, determining a lesion's biological behavior primarily on CGH is limited by a relatively small series of corroborative cases without long term follow up...
January 2012: Journal of Cutaneous Pathology
Su Luo, Alireza Sepehr, Hensin Tsao
Spitz nevi are melanocytic proliferations that are characterized by spindled and/or epithelioid nevomelanocytes. First interpreted as juvenile melanoma, these lesions were later characterized as benign and were observed to affect all age groups. Today, contrasting opinions persist regarding the fundamental benignancy versus malignancy within the spectrum of Spitz tumors. Beyond clinical outcome, this controversy has also been fueled by complex and sometimes convoluted classification schemes based on pathologic characteristics...
December 2011: Journal of the American Academy of Dermatology
Christian Posch, Michael Vesely, Babak Monshi, Hans Feichtinger, Kurt Cziegler, Klemens Rappersberger
Animal-type melanoma (ATM) represents a rare subtype within the wide spectrum of melanocytic tumors. Clinically, ATM lesions appear as sharply demarcated, brown, black and dark blue pigmented nodules, which show grey-white surface elements on dermatoscopy. The tumor is restricted to the dermis and arranged in irregular fascicles, which are composed of spindle-shaped and epithelioid melanocytes. Moderate tumor cell pleomorphism, mitoses and apoptotic cells all suggest a malignant process. Abundant, finely dispersed melanin pigment within tumor cells as well as numerous melanophages are strongly suggestive of ATM...
January 2012: Journal der Deutschen Dermatologischen Gesellschaft, Journal of the German Society of Dermatology: JDDG
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