MART‐1‐labeled melanocyte density and distribution in actinic keratosis and squamous cell cancer in situ: Pagetoid melanocytes are a potential source of misdiagnosis as melanoma in situ

Fix, William C.; Yun, Sook Jung; MacFarlane, Caroline M. Groft; Jambusaria, Anokhi; Elenitsas, Rosalie; Chu, Emily Y.; Etzkorn, Jeremy R.; Sobanko, Joseph F.; Shin, Thuzar M.; Miller, Christopher J.

doi:10.1111/cup.13309

Cited by 6 publications

(10 citation statements)

References 38 publications

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Section: Melan-a/mart-1mentioning

confidence: 84%

“…The melanocyte confluence is defined in various studies as number of adjacent pigment cells without intervening keratinocytes. While in some reports neither pagetoid spread nor nesting of melanocytes was found, 5,22,28 in another study Melan‐A staining could have suggested the presence of these features in sun‐damaged skin 25 . Although transepidermal melanocytic migration may imply the diagnosis of melanoma, it is not an independent, unequivocal sign of this malignancy 40 .…”

Section: Immunohistochemical Detectability Of Melanocytes In Intraepi...mentioning

confidence: 96%

“…However, one of its limitations turned out to be a problem in the differential diagnosis of AK and LM. Pagetoid Melan‐A positive cells were observed in 95% cases of AK 28 . The sensitivity of this marker to distinguish pigmented AK from melanoma in situ was as high as 100% but the specificity was only 17% (Table 1).…”

Section: Immunohistochemical Detectability Of Melanocytes In Intraepi...mentioning

confidence: 99%

“…Pagetoid Melan-A positive cells were observed in 95% cases of AK. 28 The sensitivity of this marker to distinguish pigmented AK from melanoma in situ was as high as 100% but the specificity was only 17% (Table 1). 29 The cytoplasmic staining of melanocytic dendrites and/or damaged keratinocytes may suggest melanocytic hyperplasia.…”

Section: Melan-a/mart-1mentioning

confidence: 99%

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The detectability of intraepidermal melanocytes—A narrative review of immunohistochemical studies

Kuźbicki

Brożyna

2022

J Cutan Pathol

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Some intraepidermal lesions, even the nonmelanocytic ones, may mimic melanoma in situ. The cytoplasmic clarity in atypical basal cells, architectural disorder with cell aggregates or nest-like structures within the epidermis often cause challenge particularly in sun-damaged skin. The aim of this review is to evaluate the effectiveness of the most often used immunohistochemical melanocyte markers in the diagnosis of intraepidermal lesions. All the analyzed markers can be useful in detection of intraepidermal melanocytes that occur more densely in lentigo maligna than in solar lentigo or sun-damaged skin. However, the number of these cells is underestimated by HMB-45 and Mel-5. The cytoplasmic Melan-A staining may overestimate melanocyte number and highlight the dendritic process. Atypical melanized keratinocytes in actinic keratoses and nest-like structures in lichenoid dermatoses may mimic atypical melanocytes in melanomas in situ. S-100 remains a marker of high sensitivity but low specificity. The nuclear localization of MITF, SOX-10, and PRAME overcomes the problem of melanosome transfer to cells of other types. Neither MITF nor SOX-10 is detectable in keratinocytes, which makes them useful in distinguishing actinic keratoses from melanomas in situ. The use of markers considered as melanocyte specific suggests that lichenoid dermatoses constitute a heterogeneous group of lesions.

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Section: Melan-a/mart-1mentioning

confidence: 84%

Section: Immunohistochemical Detectability Of Melanocytes In Intraepi...mentioning

confidence: 96%

Section: Immunohistochemical Detectability Of Melanocytes In Intraepi...mentioning

confidence: 99%

Section: Melan-a/mart-1mentioning

confidence: 99%

See 2 more Smart Citations

The detectability of intraepidermal melanocytes—A narrative review of immunohistochemical studies

Kuźbicki

Brożyna

2022

J Cutan Pathol

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“…The narrow biological relationship among several SPSs may complicate the successful diagnosis of skin cancer. Certain researches have pointed out the difficulty in discerning among specific SPSs from the clinical, histological and molecular points of view: AK vs SCC [9], AK and SCC vs PRIMEL [10], SCC vs BCC and MSC [11], primary MCC (PMCC) vs metastatic MCC (MMCC) [12], etc. Different editions of the American Joint Committee on Cancer (AJCC) have gradually introduced the most outstanding clinical parameters for their diagnosis This work is licensed under a Creative Commons Attribution 4.0 License.…”

Section: Introductionmentioning

confidence: 99%

Towards Improving Skin Cancer Diagnosis by Integrating Microarray and RNA-Seq Datasets

Gálvez

Castillo-Secilla

Herrera

et al. 2020

IEEE J. Biomed. Health Inform.

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Many clinical studies have revealed the high biological similarities existing among different skin pathological states. These similarities create difficulties in the efficient diagnosis of skin cancer, and encourage to study and design new intelligent clinical decision support systems. In this sense, gene expression analysis can help find differentially expressed genes (DEGs) simultaneously discerning multiple skin pathological states in a single test. The integration of multiple heterogeneous transcriptomic datasets requires different pipeline stages to be properly designed: from suitable batch merging and efficient biomarker selection to automated classification assessment. This article presents a novel approach addressing all these technical issues, with the intention of providing new sights about skin cancer diagnosis. Although new future efforts will have to be made in the search for better biomarkers recognizing specific skin pathological states, our study found a panel of 8 highly relevant multiclass DEGs for discerning up to 10 skin pathological states: 2 healthy skin conditions a priori, 2 cataloged precancerous skin diseases and 6 cancerous skin states. Their power of diagnosis over new samples was widely tested by previously well-trained classification models. Robust performance metrics such as overall and mean multiclass F1-score outperformed recognition rates of 94% and 80%, respectively. Clinicians should give special attention to highlighted multiclass DEGs that have high gene expression changes present among them, and understand their biological relationship to different skin pathological states.

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Histopathologic Characterization of Incidental Lesions Encountered During Mohs Micrographic Surgery With MART-1 Immunohistochemistry

Hirotsu,

Kibbi,

Rieger

et al. 2023

Dermatol Surg

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BACKGROUND As the use of melanoma antigen recognized by T cells (MART-1) immunohistochemistry (IHC) with Mohs surgery increases for the treatment of melanoma in situ and invasive melanoma, surgeons should be aware of MART-1 staining patterns of incidental lesions often encountered on frozen sections. Lack of this knowledge can lead to unnecessary additional surgery, increased health care costs, and loss of valuable laboratory staff time and resources. OBJECTIVE To characterize the histopathologic features of incidental lesions encountered during Mohs surgery for melanoma. To review key diagnostic and differentiating features on hematoxylin and eosin staining (H&E) and MART-1 IHC of these lesions. METHODS A comprehensive review of frozen-section histopathology slides from Mohs cases with MART-1 IHC at our institution was conducted from 2021 to 2023. RESULTS Incidental benign and malignant lesions were identified and characterized on H&E frozen sections and MART-1 IHC. Although such entities can share MART-1 staining characteristics with melanoma in situ or melanoma, distinguishing characteristics on H&E and lack of histopathologic criteria for melanoma on MART-1 IHC can be used to distinguish these incidental lesions from melanoma. CONCLUSION Staining of frozen sections for Mohs micrographic surgery with H&E and MART-1 IHC together can differentiate common incidental benign and malignant cutaneous lesions from melanoma.

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MART‐1‐labeled melanocyte density and distribution in actinic keratosis and squamous cell cancer in situ: Pagetoid melanocytes are a potential source of misdiagnosis as melanoma in situ

Abstract: Pagetoid melanocytes in AK and SCCIS should be interpreted with caution to avoid overdiagnosis of MIS.

Cited by 6 publications

References 38 publications

The detectability of intraepidermal melanocytes—A narrative review of immunohistochemical studies

The detectability of intraepidermal melanocytes—A narrative review of immunohistochemical studies

Towards Improving Skin Cancer Diagnosis by Integrating Microarray and RNA-Seq Datasets

Histopathologic Characterization of Incidental Lesions Encountered During Mohs Micrographic Surgery With MART-1 Immunohistochemistry

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