Yuen Joanna, AlZahrani Fatmah, Horne Garnet, Naert Karen, McCalmont Timothy, Unger Kathy, Fiorillo Loretta
Division of Dermatology, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, AB, Canada.
Department of Pathology and Laboratory Medicine, Red Deer Regional Hospital, Red Deer, AB, Canada.
SAGE Open Med Case Rep. 2019 Feb 18;7:2050313X19829630. doi: 10.1177/2050313X19829630. eCollection 2019.
Atypical Spitzoid lesions pose a distinct challenge in classification as they may comprise a mixture of both classic benign nevus and cutaneous melanoma characteristics. Immunostaining and molecular analysis, such as comparative genomic hybridization, can assist in narrowing the differential diagnosis. We present a case of a 5-year-old male with an atypical Spitzoid lesion on his back. Initial histopathology revealed a relatively symmetric lesion with mitotic figures and poor maturation of melanocytes with descent into the dermis. Immunohistochemistry demonstrated a loss of p16, and array comparative genomic hybridization revealed a loss of chromosome 9, supporting a diagnosis of invasive melanoma arising in conjunction with a remnant of a conventional melanocytic nevus. This case is the first in Canada to demonstrate the use of array comparative genomic hybridization for diagnosing melanoma in a young paediatric patient.
非典型Spitzoid病变在分类上构成了独特的挑战，因为它们可能兼具经典良性痣和皮肤黑色素瘤的特征。免疫染色和分子分析，如比较基因组杂交，有助于缩小鉴别诊断范围。我们报告一例5岁男性背部出现非典型Spitzoid病变的病例。初始组织病理学显示病变相对对称，有核分裂象，黑素细胞成熟度差且向下侵入真皮。免疫组化显示p16缺失，阵列比较基因组杂交显示9号染色体缺失，支持诊断为侵袭性黑色素瘤合并传统黑素细胞痣残留。该病例是加拿大首例展示使用阵列比较基因组杂交诊断年轻儿科患者黑色素瘤的病例。
