Follicular involvement is frequent in lentigo maligna: Implications for treatment
Follicular involvement is frequent in lentigo maligna: Implications for treatment
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DOI：
10.1016/j.jaad.2018.07.071
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发表时间：
2019-02-01
影响因子：
13.8
通讯作者：
Nehal, Kishwer
中科院分区：
文献类型：
--
作者：
Connolly, Karen L.;Giordano, Cerrene;Nehal, Kishwer
背景：恶性狼疮性毛囊受累被认为是一种组织病理学特征，但其发病率和特征尚不清楚。目的：探讨恶性黑素细胞侵袭滤泡的发生率和特点，包括黑素细胞在滤泡内生长的深度。方法：对2013-2015年间收治的100例经手术切除的扁平苔藓患者进行单中心回顾性研究。皮肤科医生和皮肤科病理学家对脱落标本上残留的LM病例进行玻片复查，以确定毛囊受累的特征。结果：在100份标本中，72份符合组织病理学评估的纳入标准。95.8%的标本受累于卵泡(95%可信区间，88.3%~99.1%)，单个标本受累卵泡的平均比例为68%。皮损黑素细胞毛囊内生长深度平均为0.45 mm(标准差为0.23；范围为0.1~1.1 mm)。在60.9%的标本中，肿瘤细胞局限于毛囊漏斗部分。结论：浅表毛囊受累在光镜下普遍存在。当考虑以肿瘤清除为目标的深度依赖方式的LM的治疗方案时，应该考虑平均和最大受累深度。
Background: Follicular involvement of lentigo maligna (LM) is considered a histopathologic hallmark, but its prevalence and characteristics have not been well defined. The depth of intrafollicular extension by neoplastic melanocytes may have clinical importance in the treatment of LM.Objective: To describe the prevalence and features of follicular involvement in LM, including depth of follicular growth by melanocytes.Methods: A single-center retrospective study of 100 consecutive cases of surgically excised LM that was treated from 2013 to 2015. The slide review for cases with residual LM on the debulk specimen was performed by a dermatologic surgeon and dermatopathologist to characterize follicular involvement.Results: Of 100 specimens, 72 met the inclusion criteria for histopathologic evaluation. Follicular involvement was seen in 95.8% of specimens (95% confidence interval, 88.3%-99.1%), with a mean of 68% of follicles involved in a single specimen. The mean depth of intrafollicular growth by lesional melanocytes was 0.45 mm (standard deviation, 0.23; range, 0.1-1.1 mm). Tumor cells were confined to the infundibular portion of the hair follicle in 60.9% of specimens.Conclusion: Superficial follicular involvement is a ubiquitous finding in LM. When treatment options for LM with a depth-dependent modality aiming for tumor clearance are being considered, mean and maximum depths of involvement should be taken into consideration.