Angiomatous type of intradermal nevi.
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Adult↗
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Results for “Nevus, Intradermal”
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Estrogen and progesterone receptors in primary cutaneous melanoma.
Using a variety of techniques, estrogen and progesterone receptors have previously been identified in variable percentages of malignant melanomas. We examined 10 primary superficial spreading melanomas (SSM) with a fluorescent hormone-binding technique for estrogen and progesterone cytoplasmic receptors. Of these 6 SSM were markedly positive for estrogen and progesterone binding. Patients with dysplastic nevus syndrome (DNS) or a family history of DNS were markedly positive for estrogen and progesterone binding. A single patient with lentigo maligna and another patient with lentigo maligna melanoma were negative for estrogen and progesterone binding. None of the 21 control intradermal nevi examined for estrogen and progesterone binding exhibited marked positivity.
Adult↗
Benign melanocytic nevus cells in axillary lymph nodes. A prospective incidence and immunohistochemical study with literature review.
Benign nevus cell aggregates (NCAs) in lymph nodes usually present as intracapsular or trabecular collections of small, uniform melanocytes that resemble those seen in intradermal melanocytic nevi. The surgical pathologist must be aware of nodal NCAs because they can mimic micrometastasis of carcinoma. Although not uncommon, the frequency with which NCAs occur is controversial. Two previous studies attempted to determine the case incidence of NCAs in axillary lymphadenectomies; widely different results were reported, ranging from .33% to 6.2%. In this study, the authors examined prospectively 300 axillary lymph node dissections containing 5186 lymph nodes, using S-100 protein immunohistochemistry as a supplemental evaluation measure, to determine the incidence of NCAs. Twenty-eight NCA-positive lymph nodes from 22 cases were found, for a 7.3% case incidence and a .54% nodal incidence; these figures were higher than those previously reported. The possible pathogenesis of this phenomenon is discussed, with a review of the literature.
Adult↗
Keratotic melanocytic nevus: a clinicopathologic and immunohistochemical study.
BACKGROUND: Epidermal hyperplasia in melanocytic nevi is a common but little-investigated phenomenon. METHODS: We prospectively examined all melanocytic nevi diagnosed in our department over an 8-month period, for the criteria of keratotic melanocytic nevus (KMN), namely the presence of marked epidermal hyperplasia with or without horn pseudocyst formation, hyperkeratosis, and papillomatosis. In addition to routine histologic review, we studied 12 representative cases with immunohistochemistry to examine expression of Ki-67, epidermal growth factor receptor (EGFR), Bcl-2, and Bax. RESULTS: From a total of 1,527 melanocytic nevi, 95 were KMN (prevalence 6%). The average age was 34 years, with a male:female ratio of 1:2. The predominant location was the trunk (76%), followed by head and neck (20%), and extremities (4%). Clinical diagnoses were atypical nevus (44%), nevus not otherwise specified (43%), and others including seborrheic keratosis, acrochordon, and basal cell carcinoma. Two KMN were junctional, 44 compound, and 49 intradermal. Twenty-three KMN (24%) had histologic features suggesting congenital onset, and 15 (16%) had mild to moderate dysplastic features. Two cases demonstrated induction of sebaceous glands. Significantly increased Ki-67 expression was detected in the hyperplastic epidermis, particularly in deeper areas related to keratinous cysts and hair follicles. Bcl-2 and Bax (anti- and pro-apoptosis proteins, respectively) and EGFR were expressed similarly in both normal and hyperplastic epidermis overlying the KMN. CONCLUSIONS: KMN are commonly biopsied skin lesions, mostly located on the trunk. Many such lesions are clinically considered atypical, in contrast to their benign histologic appearance. The epidermal hyperplasia on top of KMN demonstrates increased cellular proliferation, in the context of adequately regulated apoptosis and EGFR expression. The cellular proliferation seems to commence in hair follicles.
Adolescent↗
Neurocutaneous melanosis: an atypical presentation.
An eleven-year-old male child presented with multiple small melanocytic nevi in a generalized distribution and a giant congenital melanocytic nevus (GCMN) over the lumbosacral area since birth. He had had difficulty in walking since the age of two and a half years. Histopathological examination revealed intradermal melanocytic nevi. Serial Magnetic Resonance Imaging (MRI) scans showed brainstem atrophy with central nervous system abnormality suggestive of neuromelanosis. Clinically and histologically, the diagnosis was suggestive of neurocutaneous melanosis (NCM). The present case is reported due to its clinical presentation of quadriparesis, which has been rarely reported as a manifestation of neurocutaneous melanosis.
Brain Diseases↗
Estrogen and progesterone receptors in melanocytic lesions. Occurrence in patients with dysplastic nevus syndrome.
Estrogen and progesterone binding studies in a series of 22 melanocytic lesions from 14 patients with the dysplastic nevus syndrome were done using a fluorescent estrogen and progesterone binding technique. Melanocytic lesions from these patients, including primary cutaneous melanomas, dysplastic nevi, and benign nevi, contained large numbers of estrogen and progesterone binding cells. Comparison is made to a series of control intradermal nevi that had little or no detectable estrogen or progesterone binding. Increased hormonal binding, and possibly responsiveness, is seen in melanomas, melanoma precursor lesions such as dysplastic nevi and congenital nevi, as well as benign nevi from patients with the dysplastic nevus syndrome.
Adult↗
Persistent and recurrent blue nevi.
Persistence of common melanocytic nevi has been fairly well characterized, clinically and histologically. In contrast, persistence of blue nevi has been reported infrequently. To define this entity better, nine cases of biologically persistent and clinically recurrent blue nevi are described. The persistent lesions in four cases were spindle-fascicular blue nevi; one showed senescent or "ancient" change and one had additional deep penetrating/epithelioid blue nevus features with atypical changes worrisome for malignancy. These changes included increased cellularity, cellular pleomorphism, mitotic figures, and a lymphocytic infiltrate. Three were biphasic dendritic-sclerotic/spindle-fascicular blue nevi, one of which had atypical changes. One case was a dendritic-sclerotic ("common") blue nevus. The original histology in one case was unavailable, but the recurrence was a combined blue nevus. The interval from initial biopsy to biopsy of the recurrent lesion was often longer (mean 2.7 years) for recurrent blue nevi than for recurrent common compound or intradermal melanocytic nevi. In addition, in contrast to recurrent common melanocytic nevi, the recurrence, in at least one case, extended beyond the scar of the original excision. These cases demonstrated that blue nevi of all histiotypes and combinations are capable of persistence with clinical recurrence. The persistence usually was histologically similar to the original, but in some cases was more "cellular" because, for the most part, the excisions of the persistent lesion revealed a deeper spindle-fascicular ("cellular") component not evident in the original superficial biopsy. In two cases, the original blue nevus appeared completely banal, but the persistent/recurrent lesions were histologically distinct and demonstrated atypical histologic features. Yet, follow-up (average 3.7 years) supports benign biology. Clinical recurrence is often associated with malignant transformation in blue nevus, but this series demonstrates that malignant tumor progression is not necessarily the case. In the absence of necrosis en mass, marked cytologic atypia, and frequent mitotic figures, the described atypical morphologic parameters in previously biopsied small blue nevi are probably reactive and "pseudomalignant." Awareness of this potential change may avoid diagnostic and prognostic errors.
Adolescent↗
Effect of Q-switched alexandrite laser irradiation on dermal melanocytes of nevus of Ota.
OBJECTIVE: To investigate the effect of Q-switched alexandrite laser irradiation on dermal melanocytes of nevus of Ota. METHODS: Multiple biopsies were carried out on 4 patients with nevus of Ota before and after laser irradiation. Altogether 11 samples were examined under light microscope and 14 under transmission electron microscope. RESULTS: Immediately after laser irradiation, the dermal melanocytes were destroyed, the melanosomes were degenerated with central vesicle formation within most of them, and intradermal round vacuoles appeared. The epidermis remained intact. Three months to 1 year after irradiation, the degenerated melanosomes and cell debris were scavenged mainly by macrophages. Dermal melanocytes gradually decreased. No fibrosis was found. CONCLUSION: Q-switched alexandrite laser can selectively destroy dermal melanocytes of nevus of Ota and treat the disease safely.
Adolescent↗
Cutis verticis gyrata due to an intradermal naevus with an underlying neurofibroma.
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Adult↗
Expression profiles of melanogenesis-related genes and proteins in acquired melanocytic nevus.
UNLABELLED: We used three types of AMN to investigate the expression profiles of melanogenesis-related genes [tyrosinase, tyrosinase-related protein-1 (TRP1), dopachrome tautomerase (TRP2), Pmel-17/gp100, P-protein, and microphthalmia-associated transcription factor (MITF)], as well as tyrosinase, TRP1, Pmel-17/gp100, and MITF proteins. RESULTS: All melanogenesis-related genes examined in the junctional type were expressed in the basal epidermal layer. In the compound and intradermal types, mRNA for tyrosinase, TRP2, and MITF was expressed in all of the AMN cells. However, the expression of TRP1, P-protein, and Pmel-17/gp100 in the compound type and TRP1 in the intradermal type became weaker in accordance with the depth of the dermis layer, as compared to those levels in the basal to upper dermis layer. Although tyrosinase and Pmel-17/gp100 mRNA in the compound and intradermal types was expressed in the intraepidermal and dermal components, immunohistochemical staining showed that tyrosinase proteins were not detected in the lower dermis layer and Pmel-17/gp100 proteins were not detected in the dermis. CONCLUSIONS: Our results suggest that all nevus cells that constitute AMN tissue originate from melanocytes. Further, there may be differences in the transcription levels of melanogenesis-related genes as well as in their post-transcriptional regulation between nevus cells located in the basal epidermal to upper dermis layer and those in the lower dermis layer.
Biomarkers, Tumor↗
Intradermal melanocarcinoma--report of a case with special reference to histogenesis.
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Child↗
[Divided nevus--an embryological experiment of nature].
A "divided naevus" (or "kissing naevus") is defined as a congenital melanocytic naevus that occurs on adjacent parts of the upper and lower eyelid and may give the appearance of a single lesion when the eye is closed. We report on four cases of this rare naevus. Two of these were examined histologically and showed the features of compound naevi. The unique occurrence in nature of the divided naevus allows conclusions on the site and time of origin not only of the divided naevus, but possibly also of other congenital melanocytic naevi. The divided naevus must originate at the latest during the period of lid fusion, between the 9th and 20th week of gestation. The fact that the fusion involves only epithelial tissue suggests an epithelial origin of congenital melanocytic naevi, which may later develop secondarily into compound or intradermal naevi by way of "dropping-off".
Adolescent↗
Malignant melanoma developing from intradermal nevi.
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Breast Neoplasms↗
Clonality in nevocellular nevus and melanoma: an expression-based clonality analysis at the X-linked genes by polymerase chain reaction.
The true nature of nevocellular nevus is still unknown and it has been ambiguously classified as a neoplasm or a hamartoma. We studied the clonality of nevocellular nevus and melanoma (malignant melanoma), using an expression-based clonality analysis at the X-linked genes by means of polymerase chain reaction. DNA was extracted from cryostat sections of 20 nevocellular nevi (10 compound and 10 intradermal type) and five melanomas from female patients. A polymorphic portion of the inactivated X-linked gene was amplified after selective digestion of the active X-chromosome with a methylation-sensitive restriction enzyme, Hpa II. Paternal- and maternal-derived fragments were resolved with electrophoresis using the polymorphic restriction endonuclease (BstX I) site for the phosphoglycerate kinase assay, and using the difference of CAG repeats for the human androgen-receptor gene assay. Both assays revealed that all informative nevocellular nevi were polyclonal in origin and all melanomas were monoclonal. Results of the clonality were independent of either the histologic type of nevocellular nevus or whether the nevocellular nevus was of congenital or acquired origin. Thus, nevocellular nevus, congenital or acquired, may be a hamartomatous rather than a neoplastic lesion. The analysis of clonality could be applied to the differential diagnosis of benign melanocytic disease and melanomas.
Adolescent↗
A tridimensional view of intradermal nevi as revealed by scanning electron microscopy.
When scanning electron microscopy (SEM) was applied to the study of intradermal nevi, interesting tridimensional features were recognized. The free surface of the lesions showed ruffled keratinized cells. "Normal" hairs as well as "corkscrew" hairs emerged from the follicular openings. Nevus cells were either round or elongated and surrounded by connective tissue fibers.
Adult↗
Clefts in intradermal nevi: an ultrastructural study.
Six intradermal melanocytic nevi, two with and four without intercellular slitlike spaces, were examined by light microscopy and electron microscopy of deparaffinized tissue. The spaces were partially lined by elongated nevus cells and contained a few collagen fibrils. Other features in both groups included an abundance of (1) immature elastic tissue comprised of aggregates of microfibrils lacking an amorphous component and (2) collagen fibrils that were finer than in normal dermis and did not form compact bundles. We propose that these elastic tissue and collagen fiber changes diminish the resistance of the dermis to the mechanical stress of the biopsy procedure and histologic processing, resulting in the formation of artifactual clefts.
Adult↗
The histology and differential diagnosis of Spitz nevus.
We attempted to identify features by which Spitz nevi (SN) and melanomas that resemble SN may be distinguished, by examining the light microscopic features of 43 SN, using a multifactorial protocol. The data confirm that SN evolve in a manner similar to melanocytic nevi, with well-defined junctional, compound, and intradermal phases. Because of their growth kinetics most SN are excised at the compound stage, the most readily identifiable stage of evolution. However, almost 20% of SN are removed before or after the compound stage and at these stages they are recognized less readily. There are common characteristics of the histological features of the epidermis, junctional and dermal melanocytes, and stromal components at the different stages of SN evolution, but each stage additionally has unique characteristics. Each stage of SN has to be separated from different benign and malignant melanocytic lesions and criteria by which these separations may be made are discussed.
Diagnosis, Differential↗
Malignant melanoma cells in the eccrine apparatus.
A case of malignant melanoma arising on the sole of a 75-year-old Japanese man is presented. Histopathologically, in addition to the intraepidermal and intradermal malignant melanoma cells reaching the upper part of the dermis, cells were also found in the deep part of the ductal epithelium of the eccrine apparatus. Melanoma cells, and melanocytic nevus cells as well, are rarely found within the epithelial structure of sweat glands, yet they are frequently found in that of hair follicles. In order to avoid a residue of melanoma cells in the deep part of the eccrine apparatus, a fairly deep excision should be performed even for this melanoma.
Aged↗