Department of Dermatology, University of Puerto Rico School of Medicine, San Juan, PR.
Am J Dermatopathol. 2021 Apr 1;43(4):252-258. doi: 10.1097/DAD.0000000000001851.
Atypical intraepidermal melanocytic proliferation (AIMP) is a general term assigned to melanocytic proliferations of uncertain biological potential when a definitive histopathological diagnosis cannot be achieved. There are few data available describing the possibility of malignancy of AIMP, or ways to further define diagnosis.
To determine the rate of diagnostic change of AIMP to melanoma or melanoma in situ (MIS) after conventional excision. In addition, to determine the role of immunohistochemistry (IHC) in defining AIMP biopsies.
Retrospective cross-sectional, single-center review of biopsies with a diagnosis of AIMP with a follow-up conventional excision from 2012-2016 was performed. In a separate analysis, a search was performed for AIMP biopsied lesions in which IHC was subsequently performed.
The rate of diagnostic change of AIMP to MIS was 4.8% (8/167) after excision. Punch biopsy was a risk factor for diagnostic change to MIS (odds ratio 12.94, confidence interval 2.56-65.38, P = 0.008). The rate of diagnostic change of AIMP biopsies after examining with IHC was 21.3% (34/160) to MIS and 4.4% (7/160) to melanoma.
The possibility of malignancy of AIMP lesions must be taken into consideration when counseling patients and when planning treatment options. IHC is a useful tool and should be used in the evaluation of AIMP specimens.
非典型表皮内黑色素细胞增殖（AIMP）是一个通用术语，用于描述当无法明确组织病理学诊断时，具有不确定生物学潜能的黑色素细胞增殖。目前有关 AIMP 发生恶性转化的可能性或进一步明确诊断的方法的资料很少。
确定常规切除后 AIMP 向黑色素瘤或原位黑色素瘤（MIS）转变的诊断率。此外，还确定免疫组织化学（IHC）在定义 AIMP 活检中的作用。
回顾性分析了 2012 年至 2016 年间进行常规切除的 AIMP 活检标本，这些标本的诊断为 AIMP 且具有随访资料。在单独的分析中，对随后进行 IHC 检测的 AIMP 活检病变进行了搜索。
切除后 AIMP 转变为 MIS 的诊断率为 4.8%（8/167）。打孔活检是诊断为 MIS 的 AIMP 活检发生转变的危险因素（比值比 12.94，置信区间 2.56-65.38，P = 0.008）。经 IHC 检查后 AIMP 活检的诊断转变率为 21.3%（34/160）至 MIS 和 4.4%（7/160）至黑色素瘤。
在为患者提供咨询和制定治疗方案时，必须考虑 AIMP 病变的恶性可能性。IHC 是一种有用的工具，应在评估 AIMP 标本时使用。
