Park Chanyong, Kim Dong Hyo, Hur Keunyoung, Mun Je-Ho
Seoul National University College of Medicine, Seoul, Republic of Korea.
Department of Dermatology, Seoul National University College of Medicine, Seoul, Republic of Korea.
Front Med (Lausanne). 2024 Jan 5;10:1249796. doi: 10.3389/fmed.2023.1249796. eCollection 2023.
Lentigo maligna (LM) and lentigo maligna melanoma (LMM) are rare in Asian countries. The histopathological diagnosis of LM is often challenging, and misdiagnosis is common. Although histopathologic features of LM/LMM are known, statistical analysis of them were scarcely reported. In this study, we aimed to investigate the histopathological characteristics of LM/LMM in Korean patients and identify key histopathological clues distinguishing LM from benign lentigo.
We performed a retrospective study of the clinical and histopathological features of patients diagnosed with LM/LMM at our center between 2011 and 2022. We assessed the histopathological features in each case based on 16 pathological criteria according to previous literature. Pathologically confirmed cases of benign lentigo were analyzed for comparison.
Twenty-one patients (10 with LM and 11 with LMM) were analyzed. Several statistically significant difference existed between the features of LM and benign lentigo ( = 10), including asymmetry of overall structure ( < 0.001), cytologic atypia ( < 0.001), predominant single-cell proliferation ( < 0.001), melanocytic nests ( = 0.033), melanocytes forming rows ( = 0.003), pagetoid spread of melanocytes ( < 0.001), and hair follicle invasion by atypical melanocytes ( < 0.001). Degree of solar elastosis was more severe in group "Age ≥ 60" ( = 0.015), and group "Diameter ≥ 20 mm" ( = 0.043). Presence of elongated rete ridges were less common in the older than 60 age group ( = 0.015) and group "Diameter ≥ 20 mm." Invasion was associated with mitosis ( = 0.001, OR 49.285), multinucleated cells ( = 0.035, OR 17.769), and degree of lymphocyte infiltration ( = 0.004).
This study investigated the clinical and histopathologic characteristics of LM and LMM in Koreans. Although histopathological diagnosis is challenging, especially in the early stages of LM, our data showed essential histopathological changes in architectural, cytological, and dermal patterns. Considering the potential aggressiveness of LM/LMM, it is essential to recognize its histopathological features and provide timely management.
恶性雀斑样痣（LM）和恶性雀斑样痣黑色素瘤（LMM）在亚洲国家较为罕见。LM的组织病理学诊断往往具有挑战性，误诊很常见。尽管已知LM/LMM的组织病理学特征，但很少有对其进行统计分析的报道。在本研究中，我们旨在调查韩国患者中LM/LMM的组织病理学特征，并确定区分LM与良性雀斑样痣的关键组织病理学线索。
我们对2011年至2022年期间在本中心诊断为LM/LMM的患者的临床和组织病理学特征进行了回顾性研究。我们根据先前文献中的16项病理标准评估了每个病例的组织病理学特征。对病理确诊的良性雀斑样痣病例进行分析以作比较。
分析了21例患者（10例LM和11例LMM）。LM与良性雀斑样痣（n = 10）的特征之间存在若干统计学上的显著差异，包括整体结构不对称（P < 0.001）、细胞异型性（P < 0.001）、主要的单细胞增殖（P < 0.001）、黑素细胞巢（P = 0.033）、黑素细胞形成排（P = 0.003）、黑素细胞的派杰样扩散（P < 0.001）以及非典型黑素细胞侵犯毛囊（P < 0.001）。“年龄≥60岁”组（P = 0.015）和“直径≥20 mm”组（P = 0.043）的日光性弹力组织变性程度更严重。60岁以上年龄组（P = 0.015）和“直径≥20 mm”组中细长的 rete 嵴较少见。侵犯与有丝分裂（P = 0.001，OR 49.285）、多核细胞（P = 0.035，OR 17.769）以及淋巴细胞浸润程度（P = 0.004）相关。
本研究调查了韩国人LM和LMM的临床和组织病理学特征。尽管组织病理学诊断具有挑战性，尤其是在LM的早期阶段，但我们的数据显示了在结构、细胞学和真皮模式方面的重要组织病理学变化。考虑到LM/LMM的潜在侵袭性，认识其组织病理学特征并及时进行处理至关重要。
