mart-1-antigen and Nevus--Epithelioid-and-Spindle-Cell

The histopathologic differentiation between Spitz nevus and melanoma is of particular interest in routine diagnostic procedures of melanocytic tumors. Atypical Spitz nevi are sometimes difficult to distinguish from melanoma. There is still no single criterion that ensures a distinction of melanoma and atypical Spitz nevus. The aim of this study was to reevaluate established and new criteria to differentiate Spitz nevus from melanoma more reliably. We analyzed 25 melanomas with a Breslow index ≥ 1 mm and 18 classical compound Spitz nevi concerning their histopathologic, immunohistochemical and molecular genetic characteristics. Moreover, clinical follow-up data for 5 years were collected. We found statistically significant differences between Spitz nevus and melanoma for the following features: pagetoid spread, atypia, maturation, elastosis, Kamino bodies, p16 expression, and the staining pattern of HMB45. BRAF was positive in 7/21 melanomas and in 1/14 Spitz nevi. Fluorescence in situ hybridization confirmed the histopathologic diagnosis in 36/37 cases. The established clinical, histopathologic, and immunohistochemical criteria to differentiate Spitz nevus and melanoma could be reproduced in our collective. Especially, the expression of p16, BRAF analysis and fluorescence in situ hybridization proved to be helpful tools to improve the differentiation of Spitz nevus and melanoma in our study. Nevertheless, there is-until now-no reliable histopathologic and immunohistochemical parameter which can discriminate Spitz nevus and melanoma with absolute certainty.

Topics: Adult; Aged; Aged, 80 and over; Biomarkers, Tumor; Cyclin-Dependent Kinase Inhibitor p16; Diagnosis, Differential; Female; Follow-Up Studies; gp100 Melanoma Antigen; Humans; Immunohistochemistry; Male; MART-1 Antigen; Melanoma; Melanoma-Specific Antigens; Middle Aged; Nevus, Epithelioid and Spindle Cell; Severity of Illness Index; Skin Neoplasms

Topics: Biomarkers, Tumor; Diagnosis, Differential; Eyelid Neoplasms; Humans; Infant; Ki-67 Antigen; Male; MART-1 Antigen; Nevus, Epithelioid and Spindle Cell; Ophthalmologic Surgical Procedures; Skin Neoplasms

To date, only 12 cases of angiomatoid Spitz nevus have been characterized in the literature. We present the first case of angiomatoid Spitz nevus in which dermatoscopic findings are described.

Topics: Adult; Angiomatosis; Biomarkers, Tumor; Biopsy; Dermoscopy; Diagnosis, Differential; Humans; Male; MART-1 Antigen; Melanoma; Nevus, Epithelioid and Spindle Cell; Skin Neoplasms; Vascular Neoplasms

Topics: Antigens, Neoplasm; Biomarkers, Tumor; Cell Proliferation; Humans; Immunoenzyme Techniques; Ki-67 Antigen; Lymph Nodes; MART-1 Antigen; Melanocytes; Melanoma; Neoplasm Proteins; Nevus, Epithelioid and Spindle Cell; Retrospective Studies; Skin Neoplasms

We present the case of 10-year-old girl who have had from birth a plane tumor, of tan color, 3-4 mm of diameter, localized on the face on the cutaneous part of the superior lip. This tumor has been stabile until 8-year-old. Then, after repeated sunlight exposures, the lesion has become more stark, hemispheric in shape, has increased in size becoming about 5-6 mm, with irregular borders, and after an accidental traumatism it began to bleed. We have performed the electroexcision of the lesion for diagnostic and therapeutic purpose. The histopathologic exam distinguished typical images of Spitz nevus on some of the histological sections but also of melanocytary tumor with uncertain malignant potential on the others where atypical mitoses localized in the deeper component of the tumor are being noticed. The immunohistochemical assessment of the tumoral cells showed positivity for the melanocytic markers HMB45 and Melan A, within junctional intraepidermic nevic cells and in the nevic cells from superficial dermis, and also for CD44 protein (belonging to the adhesion molecules family). However, cyclin D1 was positive in rare nevic cells, and the proliferation rate of the tumor was small, with a proliferation index for Ki67 lesser than 5%. The correlation between histopathological and immunohistochemical data conducive to final diagnosis of Spitz nevus with uncertain malignant potential. The clinical evolution confirmed the histopathological diagnosis by the fact that the patient did not presented clinical signs of local recurrences or metastasis at three years after the excision of the tumor.

Topics: Antigens, Neoplasm; Biomarkers, Tumor; Child; Cyclin D1; Diagnosis, Differential; Female; Humans; Hyaluronan Receptors; Ki-67 Antigen; MART-1 Antigen; Melanoma; Melanoma-Specific Antigens; Neoplasm Proteins; Nevus, Epithelioid and Spindle Cell; Skin Neoplasms

At the histological examination of an increasing number of melanocytic tumors there is a need to use various immunohistochemical methods. Currently, we are supplied by several antibodies working well on formalin-fixed, paraffin-embedded samples. We have tested five antibodies (S-100, HMB-45, Melan-A, MITF, PNL-2) on 34 benign and 34 malignant melanocytic tumors. We examined the specificity and sensitivity in the junctional and dermal component separately, with special consideration to features disturbing the evaluation (regression, halo-like inflammation, etc.). We have concluded that the histological diagnosis of melanocytic tumors is based on the detailed examination of traditional HE slides and the immunohistochemical methods only confirm or weaken our opinion.

Topics: Antibodies, Monoclonal; Antigens, Neoplasm; Biomarkers, Tumor; Humans; Immunohistochemistry; MART-1 Antigen; Melanoma; Melanoma-Specific Antigens; Microphthalmia-Associated Transcription Factor; Neoplasm Proteins; Nevus; Nevus, Blue; Nevus, Epithelioid and Spindle Cell; Nevus, Spindle Cell; Paraffin Embedding; Polysaccharide-Lyases; S100 Proteins; Skin Neoplasms

Biphenotypical nevi or nevi with phenotypical heterogeneity consist of phenotypically different cell populations in a pattern other than that observed in classical combined nevi or in various maturation stages of banal nevocellular nevi. Besides several well-known entities such as deep penetrating nevi and plexiform spindle cell nevi, this category of pigment cell lesions also harbors fewer delineated lesions such as nevi with atypical dermal nodules (N-ADN) and nevi with a focal atypical epithelioid cell component (N-FAECC). Their worrisome histology may result in a wrong diagnosis of malignancy. In order to discriminate them from malignant melanoma and to shed light on their histogenesis, we analyzed the immunophenotypical profile of 33 N-FAECC, 6 N-ADN, and 10 giant congenital nevi removed shortly after birth, using antibodies directed to S100 protein, gp100, tyrosinase, NKI-C3, Melan-A and Mib-1. In N-FAECC and N-ADN, the large polygonal cells expressed gp100, S100 protein and Melan-A, and reacted with monoclonal antibody NKI-C3. In addition, there was intense tyrosinase expression but no Mib-1 immunoreactivity. Unexpectedly, we observed similar single or clustered, large epithelioid cells in three out of ten giant congenital nevi; these cells showed a similar phenotype to those observed in N-ADN and N-FAECC. Our histological and immunohistochemical data suggest that N-FAECC and N-ADN may reflect different stages of the same disorder. Moreover, their resemblance to the large polygonal cells in congenital nevi may suggest that the histogenesis of N-ADN and N-FAECC may be related to the persistence and expansion of large epithelioid cells in congenital nevi shortly after birth.

Topics: Antigens, Neoplasm; Diagnosis, Differential; gp100 Melanoma Antigen; Humans; Immunohistochemistry; Infant, Newborn; MART-1 Antigen; Membrane Glycoproteins; Monophenol Monooxygenase; Neoplasm Proteins; Nevus; Nevus, Epithelioid and Spindle Cell; Nevus, Pigmented; Phenotype; S100 Proteins; Skin Neoplasms

The histopathologic differential diagnosis of Spitz nevus (SN) from malignant melanoma (MM) may be difficult.. We attempted to elucidate the pattern of expression of a newly recognized melanocyte-specific melanosomal protein MART-1 in routinely processed specimens of SNs, MMs, and ordinary melanocytic nevi (MNs) and to see whether it can help to differentiate between them.. Twenty SN, 22 MM, and 27 ordinary MN were immunostained with anti-MART-1 monoclonal antibody (clone A103).. All SNs, MNs, and MMs demonstrated cytoplasmic staining for MART-1 in some of their tumor cells, of which 17 of 20 (85%) and 24 of 27 (89%) of SN and MN, respectively, demonstrated positive stainings in more than half of their tumor cells, as compared with only 10 of 22 (45%) of the MM (P <.05). The majority of lesions in all 3 types of tumors showed a homogeneous mode of staining, although MM tended to show a more heterogeneous pattern. A consistent pattern of stratification of staining with progressive descent into the dermis was not demonstrated in these tumors.. MART-1 does not differentiate between SN, MM, and ordinary MN in a consistent pattern, but it may be used as a marker for these tumors.

Topics: Antigens, Neoplasm; Diagnosis, Differential; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; MART-1 Antigen; Melanoma; Neoplasm Proteins; Nevus, Epithelioid and Spindle Cell; Nevus, Pigmented; Skin Neoplasms

Epithelioid blue nevus is a rare variant of blue nevus that has been recently described in patients with Carney complex. Some of the patients with Carney complex have multiple epithelioid blue nevi and a familial history of similar lesions is often recorded. Epithelioid blue nevus consists of an intradermal melanocytic nevus composed of polygonal epithelioid cells laden with melanin. Neoplastic cells show no maturation at the base of the lesion and, in contrast with the usual stromal changes in blue nevi, epithelioid blue nevus exhibits no fibrosis of the dermis. We have studied three cases of epithelioid blue nevus in three patients with no evidence of Carney complex. The lesions were solitary and there was no family history of similar lesions. Therefore, epithelioid blue nevus is a distinctive variant of blue nevus that may also appear as a sporadic lesion and is not always associated with Carney complex.

Topics: Adult; Antigens, Neoplasm; Biomarkers, Tumor; Female; Humans; Immunohistochemistry; Male; MART-1 Antigen; Middle Aged; Neoplasm Proteins; Neoplastic Syndromes, Hereditary; Nevus, Blue; Nevus, Epithelioid and Spindle Cell; Skin Neoplasms