Kacerovska Denisa, Requena Luis, Carlson J Andrew, Santonja Carlos, Michal Michal, Bouda Jiri, Konstantinova Anastasia M, Kaspirkova Jana, Fikrle Tomas, Rotter Leopold, Kazakov Dmitry V
*Sikl's Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; †Bioptical Laboratory, Pilsen, Czech Republic; ‡Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; §Division of Dermatopathology, Albany Medical College, Albany, NY; ¶Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; ‖Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; **Department of Pathology, Clinical Oncological Scientific and Practical Centre for Specialized Medical Care, Saint Petersburg, Russia; ††Department of Dermatovenereology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; and ‡‡Reprofit International, Clinic of Reproductive Medicine and Gynecology, Brno, Czech Republic.
Am J Dermatopathol. 2014 Jun;36(6):471-7. doi: 10.1097/DAD.0000000000000007.
Pigmented lesions in the anogenital area encompass a wide variety of disorders including squamous intraepithelial neoplasia. The authors sought to explore the mechanism(s) underlying clinically pigmented squamous intraepithelial neoplasia in the anogenital area. A light-microscopic and immunohistochemical study of 64 lesional specimens from 45 patients (32 women, 13 men; age range, 23-73 years) with pigmented lesions in the anogenital area was performed. Histopathologically, 63 (98%) specimens showed melanin incontinence into the superficial dermis beneath the dysplastic epithelium. A focal or total loss of basilar hyperpigmentation was detected in 30 (48%) and 13 (20%) of lesions, respectively. In 17 (27%) cases, absence of basal layer hyperpigmentation was accompanied by a subepithelial lichenoid infiltrate. Melanin within the upper part of dysplastic areas were seen in 63 cases (98%), whereas dendritic melanocytes colonization, mild in all but 1 specimen case, was observed in 53 (83%) cases. All cases proved to be the usual type of squamous intraepithelial neoplasia; no single case of the simplex (differentiated) variant was present. The main mechanisms of pigmented squamous intraepithelial neoplasia of the anogenital area include melanin incontinence and occurrence of melanin in dysplastic keratinocytes. Colonization of the dysplastic epithelium by dendritic melanocytes seems to contribute, but it is rarely a prominent feature.
肛门生殖器区域的色素沉着性病变涵盖多种疾病，包括鳞状上皮内瘤变。作者试图探究肛门生殖器区域临床色素沉着性鳞状上皮内瘤变的潜在机制。对45例（32例女性，13例男性；年龄范围23 - 73岁）肛门生殖器区域有色素沉着性病变的患者的64个病变标本进行了光镜和免疫组化研究。组织病理学上，63个（98%）标本显示黑色素失禁至发育异常上皮下方的浅表真皮层。分别在30个（48%）和13个（20%）病变中检测到基底色素沉着局部或完全缺失。在17个（27%）病例中，基底细胞层色素沉着缺失伴有上皮下苔藓样浸润。63例（98%）发育异常区域上部可见黑色素，而在53例（83%）病例中观察到树枝状黑素细胞定植，除1个标本病例外均较轻微。所有病例均为常见类型的鳞状上皮内瘤变；未出现单纯型（分化型）变体的病例。肛门生殖器区域色素沉着性鳞状上皮内瘤变的主要机制包括黑色素失禁和发育异常角质形成细胞中黑色素的出现。树枝状黑素细胞对发育异常上皮的定植似乎有作用，但很少是突出特征。
