Kamino Hideko, Tam Sam, Roses Daniel, Toussaint Sonia
Department of Dermatology, New York University Langone Medical Center, New York, NY, USA.
J Cutan Pathol. 2010 Jul;37(7):723-9. doi: 10.1111/j.1600-0560.2010.01531.x. Epub 2010 Feb 24.
Although histopathologic identification of regression of melanoma is usually straightforward, sometimes it can be difficult to distinguish it from scarring fibrosis. Therefore, this study investigates the elastic fiber pattern in melanomas associated with either regression or scars.
We compared 33 invasive melanomas with the fibrosing stage of regression to 10 cases of invasive melanomas with scarring fibrosis. None of the regression cases had a prior surgical procedure. Elastic fiber patterns were evaluated with Verhoeff's elastic van Gieson stain (EVG) and elastin immunostain.
Elastin immunostain was superior to EVG in revealing the elastic fiber patterns. Both regression and scars had decreased to absent elastic fibers in the areas of fibrosis. However, areas of regression had a well-defined compressed layer of thin elastic fibers pushed down from the papillary dermis to the base of the fibrosis. In contrast, the base of scars lacked this compressed elastic layer and had instead an abrupt transition to the thick elastic fibers of the spared reticular dermis.
We have identified distinct changes of the elastic tissue network, which more accurately define the presence of regression in melanoma and distinguish it from scarring fibrosis.
尽管黑色素瘤消退的组织病理学鉴定通常很直接，但有时很难将其与瘢痕纤维化区分开来。因此，本研究调查了与消退或瘢痕相关的黑色素瘤中的弹性纤维模式。
我们将33例处于消退纤维化阶段的浸润性黑色素瘤与10例伴有瘢痕纤维化的浸润性黑色素瘤进行了比较。所有消退病例均未进行过先前的手术。用Verhoeff弹性范吉森染色（EVG）和弹性蛋白免疫染色评估弹性纤维模式。
在显示弹性纤维模式方面，弹性蛋白免疫染色优于EVG。消退和瘢痕在纤维化区域的弹性纤维均减少至消失。然而，消退区域有一层明确的薄弹性纤维压缩层，从乳头真皮向下推至纤维化底部。相比之下，瘢痕底部缺乏这种压缩弹性层，而是突然过渡到未受影响的网状真皮的厚弹性纤维。
我们确定了弹性组织网络的明显变化，这能更准确地界定黑色素瘤中消退的存在，并将其与瘢痕纤维化区分开来。
