Fujimoto Masakazu, Basko-Plluska Juliana L, Krausz Thomas, Selim Maria Angelica, Shea Christopher R
Department of Medicine, Section of Dermatology, The University of Chicago Medicine, Chicago, IL, USA.
Department of Diagnostic Pathology, Kyoto University Hospital, Kyoto, Japan.
J Cutan Pathol. 2015 Jun;42(6):394-9. doi: 10.1111/cup.12479. Epub 2015 Mar 27.
Dermal melanophages are frequently encountered in both benign melanocytic nevi and malignant melanoma. In contrast, intraepidermal melanophages (IEM) are under-recognized in melanocytic lesions and their biologic significance is not understood. Herein, we report the clinical and histopathologic features of five melanocytic lesions featuring IEM encountered prospectively in our dermatopathology practice at the University of Chicago. Two hundred and thirty-one (231) archived skin primary melanocytic proliferations were also investigated retrospectively in a de-identified, archival teaching set collection. Nineteen of 231 of the archived cases were positive for IEM. Among the total 24 IEM-positive cases (5 prospective and 19 archived cases), 13 were categorized as Spitz nevi (p < 0.0001) and 3 as atypical Spitz tumors (p = 0.0152). Fourteen of 24 cases with IEM also exhibited intracorneal melanocytes (p < 0.0001). IEM are evidently not rare, especially in spitzoid melanocytic neoplasms. IEM in our series were significantly correlated with intracorneal melanocytosis, possibly indicating an association between IEM and suprabasal melanocytosis and/or transepidermal elimination of melanocytes.
真皮黑素细胞在良性黑素细胞痣和恶性黑色素瘤中均很常见。相比之下，表皮内黑素细胞（IEM）在黑素细胞病变中未得到充分认识，其生物学意义尚不清楚。在此，我们报告了在芝加哥大学皮肤科病理学实践中前瞻性遇到的5例具有IEM的黑素细胞病变的临床和组织病理学特征。我们还对231例存档的皮肤原发性黑素细胞增殖病例进行了回顾性研究，这些病例来自一个经过身份识别处理的存档教学病例集。231例存档病例中有19例IEM呈阳性。在总共24例IEM阳性病例（5例前瞻性病例和19例存档病例）中，13例被归类为Spitz痣（p<0.0001），3例为非典型Spitz肿瘤（p=0.0152）。24例有IEM的病例中有14例也表现出角膜内黑素细胞（p<0.0001）。IEM显然并不罕见，尤其是在Spitz样黑素细胞肿瘤中。我们系列中的IEM与角膜内黑素细胞增多显著相关，这可能表明IEM与基底层上黑素细胞增多和/或黑素细胞的经表皮清除之间存在关联。
