Cramer S F
Department of Pathology, Rochester General Hospital, University of Rochester School of Medicine, NY 14621.
Arch Pathol Lab Med. 1991 Feb;115(2):115-9.
Among the most venerable concepts in dermatopathology is Unna's 19th century notion of Abtropfung, ie, that melanocytes drop off from the epidermis to the dermis during the histogenesis of melanocytic tumors. Paradoxically, however, Unna's basic premise of an epidermal origin for melanocytes has been seriously questioned for over 40 years, based on experimental evidence favoring a neural crest origin for melanocytes. Recent work has strengthened the evidence for a neural crest origin of epidermal melanocytes, and it has been suggested that the concept of Abtropfung be replaced by the concept of Hochsteigerung. The concept of Hochsteigerung holds that melanocytes migrate up from the dermis into the epidermis-not only in normal development, but also during normal tissue maintenance. It now seems likely that the precursor of melanocytes, in both normal and abnormal differentiation, may not be a melanoblast (a primitive cell committed to melanocytic differentiation) but rather a pluripotential cell. Although axon-investing Schwann cells have been the traditional focus as the closest relative of the epidermal melanocyte, recent studies suggest that another nerve sheath cell, the perineural cell, might be a better candidate. These concepts have profound implications for the histogenesis of melanocytic nevi and melanomas.
皮肤病理学中最古老的概念之一是19世纪Unna提出的“滴流”概念,即黑素细胞在黑素细胞肿瘤的组织发生过程中从表皮脱落至真皮。然而,矛盾的是,基于支持黑素细胞起源于神经嵴的实验证据,Unna关于黑素细胞起源于表皮的基本前提在40多年来一直受到严重质疑。最近的研究进一步证实了表皮黑素细胞起源于神经嵴的证据,有人建议用“上移”概念取代“滴流”概念。“上移”概念认为,黑素细胞从真皮迁移至表皮——不仅在正常发育过程中如此,在正常组织维持过程中也是如此。现在看来,在正常和异常分化过程中,黑素细胞的前体可能不是成黑素细胞(一种致力于黑素细胞分化的原始细胞),而是一种多能细胞。尽管包绕轴突的施万细胞一直是作为表皮黑素细胞最密切相关的传统研究对象,但最近的研究表明,另一种神经鞘细胞,即神经周细胞,可能是更好选择。这些概念对黑素细胞痣和黑色素瘤的组织发生具有深远影响。