Huwait Hassan, Hijazi Nouf, Martinka Magdalena, Crawford Richard I
Department of Pathology and Laboratory Medicine and Department of Dermatology and Skin Science, University of British Columbia, Vancouver, Canada.
Am J Dermatopathol. 2014 Apr;36(4):340-3. doi: 10.1097/DAD.0b013e3182a7aa7c.
Dysplastic nevi may occasionally display alarming histological features. One of these features is the presence of upward spread of melanocytes (pagetoid melanocytosis), identified either on routine histologic sections or after immunohistochemistry using one of the melanocytic markers. Forty-three cases of dysplastic nevi with mild to moderate atypia were selected and retrieved, and Melan-A staining was performed. Melan-A-positive cells with pagetoid architecture were present in 27 cases (63%). Of these, only 5 cases demonstrated pagetoid architecture on routine staining. It is concluded that Melan-A staining should be used only with caution as an adjunct to routine histology in the evaluation of dysplastic nevi with mild to moderate atypia because the identification of pagetoid melanocytosis using this technique has the potential to lead to an erroneous diagnosis of melanoma.
发育异常痣偶尔可能表现出令人担忧的组织学特征。其中一个特征是黑素细胞向上扩散（派杰样黑素ocytosis），这可在常规组织学切片上识别，或在使用黑素细胞标记物之一进行免疫组织化学后识别。选取并检索了43例轻度至中度异型性的发育异常痣病例，并进行了Melan - A染色。27例（63%）存在具有派杰样结构的Melan - A阳性细胞。其中，仅5例在常规染色中显示派杰样结构。结论是，在评估轻度至中度异型性的发育异常痣时，Melan - A染色作为常规组织学的辅助手段应谨慎使用，因为使用该技术识别派杰样黑素ocytosis有可能导致对黑色素瘤的错误诊断。
