Clinicopathological, immunohistochemical and fluorescence in‐situ hybridisation features of early subungual melanoma: an analysis of 65 cases
| Autor: | Min Ren, Xu Cai, Bo Dai, Jin-Cheng Kong, Xuxia Shen, Jing Ren, Yun-Yi Kong |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Adult
Male 0301 basic medicine Pathology medicine.medical_specialty Skin Neoplasms Histology Melanocyte Pathology and Forensic Medicine Cohort Studies Breslow Thickness Nail Diseases 03 medical and health sciences MART-1 Antigen 0302 clinical medicine Biomarkers Tumor medicine Humans Nuclear atypia Melanoma In Situ Hybridization Fluorescence Retrospective Studies Skin medicine.diagnostic_test SOXE Transcription Factors business.industry S100 Proteins General Medicine Middle Aged medicine.disease Immunohistochemistry Staining 030104 developmental biology medicine.anatomical_structure 030220 oncology & carcinogenesis Monoclonal Melanocytes Female business Fluorescence in situ hybridization |
| Zdroj: | Histopathology. 78:717-726 |
| ISSN: | 1365-2559 0309-0167 |
| DOI: | 10.1111/his.14279 |
| Popis: | Aims Very limited data are available concerning the clinicopathological and molecular features of early subungual melanoma (SM), especially with regard to the Asian population. The aim of this study was to investigate the clinical, histological, immunohistochemical and chromosomal features of early SM. Methods and results Fifty-two in-situ and 13 thin (Breslow thickness ≤1.0 mm) SM cases were retrospectively reviewed. All patients presented with longitudinal melanonychia involving a single digit, and the thumb was the most affected digit (35 of 65, 53.8%). Microscopically, most cases showed small to medium nuclear enlargement (58 of 65) and mild to moderate nuclear atypia (57 of 65). Hyperchromatism and irregular contours of nuclei were persistent features in all cases. The variation of melanocyte count (the number of melanocytes per mm dermal-epithelial junction) ranged from 31 to 255. Intra-epithelial mitoses were identified in 34 cases (52.3%). Statistically, features of in-situ lesions including higher melanocyte count (>70), presence of multinucleated melanocytes, inflammatory infiltrate and cutaneous adnexal extension, were associated with early invasion. Melan-A, human melanoma B (HMB)45, mouse monoclonal melanoma antibody (PNL2) and SOX10 antibodies (>95.0%) showed superior diagnostic sensitivity to S-100 protein (83.1%). Fluorescence in-situ hybridisation (FISH) results were positive in 15 of 23 successfully analysed cases. Conclusions To the best of our knowledge, this is the largest single-institution study of early SM in an Asian population, and the largest cohort tested by FISH. Early SM mainly showed small to medium nuclear enlargement and mild to moderate nuclear atypia. High melanocyte count, hyperchromatism and irregular contours of nuclei and intra-epithelial mitoses are crucial diagnostic parameters. Immunohistochemistry, especially SOX10 staining, and FISH analysis are valuable in the diagnosis of SM. |
| Databáze: | OpenAIRE |
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