MELANOCYTIC NEVI WITH FOCAL ATYPICAL EPITHELIOID CELL COMPONENTS - A REVIEW OF 73 CASES
MELANOCYTIC NEVI WITH FOCAL ATYPICAL EPITHELIOID CELL COMPONENTS - A REVIEW OF 73 CASES
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DOI：
10.1016/s0190-9622(08)81502-2
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发表时间：
1994-05-01
影响因子：
13.8
通讯作者：
GOLITZ, LE
中科院分区：
文献类型：
--
作者：
BALL, NJ;GOLITZ, LE
背景：我们报告了一种可能与黑色素瘤混淆的黑色素细胞痣的变种。目的：探讨伴局灶性非典型上皮样细胞样痣(克隆性痣)的临床、组织学和生物学特征。方法：对73例临床诊断为克隆性、混合型、深穿透性和内翻型A型痣的病例进行分析。组织学特征进行评估，转诊医生收到关于每个病例的表现和结果的调查问卷。结果：所有病例在组织学上都具有双相模式，其特征是在真皮浅层有大量不同的上皮样黑素细胞的深色色素沉着的黑痣。免疫组织化学染色在50%的真皮克隆(9/18)中发现突变的P53蛋白，但在克隆附近的普通痣细胞中未发现。我们没有发现任何患者发展为恶性黑色素瘤(平均24.5个月)，包括41例最初未完全切除的患者。结论：克隆性痣是黑色素细胞痣的一种独特的变种，应与发生于先前存在的痣的恶性黑色素瘤相鉴别。
Background: We report a variant of melanocytic nevus that may be confused with melanoma. Objective: The purpose of this study is to describe the clinical, histologic, and biologic features of nevi with focal atypical epithelioid cell components (clonal nevi).Methods: Seventy-three cases were retrieved by reviewing lesions previously diagnosed as clonal, combined, deep penetrating, and inverted type-A nevi. Histologic features were assessed and referring physicians received a questionnaire about the presentation and outcome of each case.Results: Histologically, all cases had a biphasic pattern characterized by an ordinary nevus that contained a darkly pigmented collection of large distinct epithelioid melanocytes in the superficial dermis. Immunostains identified mutant p53 proteins in 50% of dermal clones (9 of 18) but not in ordinary nevus cells adjacent to the clones. We are not aware of any patient developing a malignant melanoma (mean follow-up 24.5 months), including 41 cases that were initially incompletely excised.Conclusion: Clonal nevi are a distinct variant of melanocytic nevi and should be distinguished from malignant melanoma arising in a preexisting nevus.