Sommer Lacy L, Barcia Sara M, Clarke Loren E, Helm Klaus F
Temple University School of Medicine, Philadelphia, PA, USA.
J Cutan Pathol. 2011 Jun;38(6):503-7. doi: 10.1111/j.1600-0560.2011.01692.x. Epub 2011 Mar 1.
Melanocytic nevi can recur or persist if not completely excised and are capable of mimicking malignant melanoma, both clinically and histologically.
To characterize the impact of anatomic site, biopsy method, size, margin involvement and type of original melanocytic nevus on recurrence/persistence of melanocytic nevi. Secondarily, we sought to determine if the original type of melanocytic nevus could be determined solely from microscopic examination of the recurrent/persistent nevus.
One hundred and eighty-five patients with 205 persistent nevi were identified. Of these, 108 cases had original biopsy specimens available for review. Location, original biopsy size, biopsy method, margins and interval to recurrence were recorded for each. A group of 232 non-persistent nevi was established as a control population.
There was a female predominance in persistent nevi with the back being the most common site for persistence. Dysplastic melanocytic nevi were the most likely to persist. Accurate determination of the original type of melanocytic nevus from microscopic examination of the persistent nevus was possible in only 67% of the cases.
Clinicians should take larger and deeper biopsies of clinically dysplastic and conventional melanocytic nevi on the back to prevent recurrences. Grading atypia of the persistent melanocytic nevi is unreliable.
黑素细胞痣若未被完全切除，可能会复发或持续存在，并且在临床和组织学上都可能酷似恶性黑色素瘤。
描述解剖部位、活检方法、大小、切缘受累情况及原黑素细胞痣类型对黑素细胞痣复发/持续存在的影响。其次，我们试图确定是否仅通过对复发/持续存在的痣进行显微镜检查就能确定原黑素细胞痣的类型。
确定了185例有205个持续存在的痣的患者。其中，108例有原活检标本可供复查。记录每例的位置、原活检大小、活检方法、切缘及复发间隔时间。设立一组232个非持续存在的痣作为对照人群。
持续存在的痣中女性居多；背部是最常见的持续存在部位。发育异常性黑素细胞痣最易持续存在。仅在67%的病例中，通过对持续存在的痣进行显微镜检查能够准确确定原黑素细胞痣的类型。
临床医生应对背部临床上发育异常和普通的黑素细胞痣进行更大范围、更深层次的活检，以防止复发。对持续存在的黑素细胞痣进行非典型分级并不可靠。
