Kokta Victor, Hung Tawny, Al Dhaybi Rola, Lugassy Claire, Barnhill Raymond L
Department of Pathology, CHU Sainte-Justine, University of Montreal, Montreal, Quebec, Canada.
Am J Dermatopathol. 2013 Apr;35(2):180-3. doi: 10.1097/DAD.0b013e318260908c.
The mechanisms responsible for the development of congenital melanocytic nevi (CMN) have yet to be elucidated. A potential clue to their origin is the observation of angiotropism of nevus cells in CMN. Interestingly, neural crest stem cells (NCSCs), the precursors of melanocytes, demonstrate angiotropism in the embryo. There is accumulating evidence that NCSCs migrate along the external surfaces of vessels during a portion of their journey to the skin. Comparable angiotropism and migration of melanoma cells have been described as extravascular migratory metastasis in melanoma. In this report, we systematically examined for the first time, the frequency of angiotropism in 53 CMN. The lesions originated from 27 females and 26 males with an average age of 9.81 years (range 0.42-28 years). The mean nevus size was 7.43 cm (range 0.3-40 cm). Twenty-seven (50.9%) of the 53 lesions were less than 1.5 cm in diameter. Sixteen nevi (30.2%) were medium sized (1.5-19.9 cm), and 10 CMN (18.9%) were large/giant (>20 cm in diameter). The trunk was the most common location (23/53) followed by the head and neck (17/53). Thirty-eight (71.7%) of the 53 lesions were compound melanocytic nevi, and 15 (28.3%) of the 53 lesions were dermal nevi. In summary, angiotropism was observed in 50 (94.3%) of 53 cases. Consequently, such angiotropism may potentially explain the origin of the precursor cells giving rise to CMN. Further explanations concerning dysregulated growth are clearly needed for the actual appearance of CMN and their physical characteristics.
先天性黑素细胞痣（CMN）发生发展的机制尚未阐明。其起源的一个潜在线索是观察到CMN中痣细胞的向血管性。有趣的是，黑素细胞的前体——神经嵴干细胞（NCSCs）在胚胎中表现出向血管性。越来越多的证据表明，NCSCs在其迁移至皮肤的部分行程中沿着血管外表面迁移。黑色素瘤细胞类似的向血管性和迁移已被描述为黑色素瘤的血管外迁移转移。在本报告中，我们首次系统地检查了53例CMN中向血管性的发生率。这些病变来自27名女性和26名男性，平均年龄为9.81岁（范围0.42 - 28岁）。痣的平均大小为7.43厘米（范围0.3 - 40厘米）。53个病变中有27个（50.9%）直径小于1.5厘米。16个痣（30.2%）为中等大小（1.5 - 19.9厘米），10个CMN（18.9%）为大/巨大型（直径>20厘米）。躯干是最常见的部位（23/53），其次是头颈部（17/53）。53个病变中有38个（71.7%）为复合性黑素细胞痣，53个病变中有15个（28.3%）为皮内痣。总之，53例中有50例（94.3%）观察到向血管性。因此，这种向血管性可能潜在地解释了产生CMN的前体细胞的起源。对于CMN的实际外观及其物理特征，显然需要进一步解释其生长失调的情况。
