George Eva Vertes, Kalen Jessica E, Kapil Jyoti P, Motaparthi Kiran
Department of Dermatology, University of Florida College of Medicine, Gainesville, FL.
Inform Diagnostics Research Institute, Irving, TX.
Am J Dermatopathol. 2019 Jul;41(7):480-487. doi: 10.1097/DAD.0000000000001346.
Tumoral melanosis (TM) is a histologic diagnosis characterized by abundant pigment-laden macrophages in the dermis. It is generally thought to represent a regressed melanoma, although it has also been reported after benign pigmented lesions as well. Determining the antecedent lesion in cases of TM is of clinical importance to accurately guide therapy and prognostication. Comparing the histopathologic and immunohistochemical (IHC) characteristics of TM, halo nevi (HN), and regressing melanoma (RM) may help predict the antecedent lesion in cases of TM.
Cases of TM, HN, and RM were selected and assessed for histopathologic (preservation of junctional melanocytic component, depth and width, solar elastosis, fibrosis, and preservation of rete ridge architecture) and IHC (SOX-10, CD138, and PD-1) parameters. PD-L1 immunostaining was also evaluated in cases of HN and RM.
Severe solar elastosis, fibrosis, and marked rete ridge effacement were more frequent in RM than in HN. By contrast, numerous plasma cells, clusters of lymphocytes expressing PD-1, and >50% PD-L1 expression in melanocytes were more common in HN than in RM. However, the association of these variables did not reach statistical significance.
Although studies with higher statistical power are needed, this study serves as an initial investigation to characterize the histopathologic and IHC characteristics, which may help better understand TM and its precursor lesions.
肿瘤性黑素沉着症（TM）是一种组织学诊断，其特征为真皮内有大量含色素巨噬细胞。一般认为它代表消退的黑色素瘤，不过也有报道称在良性色素性病变后也会出现。确定TM病例的先前病变对于准确指导治疗和预后具有临床重要性。比较TM、晕痣（HN）和消退期黑色素瘤（RM）的组织病理学和免疫组化（IHC）特征可能有助于预测TM病例的先前病变。
选取TM、HN和RM病例，评估其组织病理学（交界性黑素细胞成分的保留、深度和宽度、日光性弹力组织变性、纤维化以及 rete 嵴结构的保留）和IHC（SOX-10、CD138和PD-1）参数。还对HN和RM病例进行了PD-L1免疫染色评估。
RM中严重的日光性弹力组织变性、纤维化和明显的 rete 嵴消失比HN更常见。相比之下，HN中大量浆细胞、表达PD-1的淋巴细胞簇以及黑素细胞中>50%的PD-L1表达比RM更常见。然而，这些变量之间的关联未达到统计学意义。
尽管需要进行统计学效力更高的研究，但本研究作为一项初步调查，旨在描述组织病理学和IHC特征，这可能有助于更好地理解TM及其前驱病变。
