Melanocytic Nevi In Sentinel Lymph Nodes - Association With Cutaneous Nevi And Clinical Relevance In Patients With Cutaneous Melanomas

Abstract

Purpose: Melanocytic nevi in lymph nodes (NNs) are an important histological differential diagnosis of initial sentinel lymph node (SN) metastasis in melanoma. Our aim was to associate NN in SNs with clinicopathologic features and survival rates in 1 250 patients with SN biopsy for melanoma. Methods: To compare patients with present and absent NN, we used Fisher's exact test, Mann-Whitney U test, and multivariate logistic regression models in this retrospective observational study based on a prospectively maintained institutional database.Results: NN prevalence in axillary, cervical, and groin SNs was 16.5%, 19.4%, and 9.8%, respectively. NN were observed in combination with all growth patterns of melanoma, but more frequently when the primary was histologically associated with a cutaneous nevus. We observed a decreasing NN prevalence with increasing SN metastasis diameter. Multiple logistic regression determined a significantly increased NN probability for SNs of the neck or axilla, for individuals with ≥50 cutaneous nevi, midline primary melanomas, and for individuals who reported non-cutaneous malignancies in their parents. Cancer in parents was also significantly more frequently reported by melanoma patients who had more than 50 cutaneous nevi. In SN-negative patients, NN indicated a tendency for slightly lower melanoma-specific survival.Conclusions: We found a highly significant association between NN diagnosis and multiple cutaneous nevi and provided circumstantial evidence that cutaneous nevi in the drainage area of lymph nodes are particularly important. The trend toward lower melanoma-specific survival in SN-negative patients with NN suggests that careful differentiation of SN metastases is important.

Left‐sided excess in the laterality of cutaneous melanocytic nevi and melanomas

“…In addition, we were not able to detect a significantly stronger left‐sided excess in individuals with more than one annual sunburn in childhood or with higher weekly sun exposure. However, the absence of asymmetry in the left/right distribution of melanocytic nevi in SNs [32], which are never exposed to ultraviolet rays, and the absence of a significant asymmetry in minimally sun‐exposed skin underline the importance of sun‐exposure for the lateralization of melanocytic tumors.…”

Linksüberhang in der Verteilung von melanozytären Nävi und Melanomen

“…Darüber hinaus konnten wir bei Personen mit anamnestisch mehr als einem jährlichen Sonnenbrand in der Kindheit oder mit höherer wöchentlicher Sonnenexposition keinen signifikant stärkeren Linksüberhang feststellen. Das Fehlen einer Asymmetrie in der Links/Rechts‐Verteilung von Nävi in SNs [32], die nie ultravioletter Strahlung ausgesetzt sind, und das Fehlen einer signifikanten Asymmetrie bei minimal sonnenexponierter Haut unterstreichen jedoch die Bedeutung der Besonnung für die Lateralisierung melanozytärer Tumoren.…”