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Melanoma coexisting with solar elastosis: a potential pitfall in the differential diagnosis between nevus and melanoma

机译:黑色素瘤与太阳能弹性源共存:痣和黑素瘤之间的鉴别诊断中的潜在缺陷

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摘要

Melanomas, like nonmelanoma skin cancers, are known to be causally related to sun exposure. It is therefore not surprising to see benign nevi and melanomas in a background of solar damage, which at times may complicate their distinction. Because of their long-standing nature, nevi often occur before the development of solar elastosis and as such are intimately associated with the solar elastosis. In contrast, visible solar elastosis often occurs before the development of melanoma, in which case the band of solar elastosis is displaced downward from the overlying invasive melanoma and/or its host response. We describe 4 cases in which invasive melanoma cells were intimately admixed with actinically damaged elastin fibers in the absence of a prominent host response. In each case, melanoma cells were admixed with prominent solar elastosis and lacked a significant host response, suggesting that they were either histiocytes or an associated melanocytic nevus. Recognition of this potential pitfall may be helpful in the diagnosis of primary/in-transit/satellite/metastatic melanoma as well as when evaluating marginal status and determining Breslow thickness. (C) 2018 Elsevier Inc. All rights reserved.
机译:Melanomas,如非棉状瘤皮肤癌,众所周知与阳光照射有关。因此,在太阳损伤的背景下,看到良性痣和黑色素瘤并不令人惊讶的是,有时可能使他们的区别复杂化。由于他们的长期性,痣经常发生在太阳能弹性症的发展之前,因此与太阳能弹性症密切相关。相比之下,可见的太阳能弹性源经常发生在黑色素瘤的发育之前,在这种情况下,太阳能弹性频带从覆盖的侵入性黑色素瘤和/或其宿主反应向下移位。我们描述了4例,其中侵入性黑素瘤细胞在没有突出的宿主反应的情况下将侵袭性黑素瘤细胞紧密地混合在一直受损的弹性蛋白纤维中。在每种情况下,黑色素瘤细胞与突出的太阳弹性症混合并缺乏显着的宿主反应,表明它们是组织细胞或相关的黑脲肾。识别这种潜在的缺陷可能有助于诊断初级/途中/卫星/转移性黑素瘤以及在评估边缘状态并确定BRESLOW厚度时。 (c)2018年Elsevier Inc.保留所有权利。

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