Melanoma in situ versus melanocytic hyperplasia in sun-damaged skin. Assessment of the significance of histopathologic criteria for differential diagnosis.
For differentiation of melanoma in situ (MIS) from melanocytic hyperplasia (MH) in sun-damaged skin, several criteria have been proposed. To assess sensitivity and specificity of those criteria, we examined the epidermis adjacent to 50 consecutive basal cell carcinomas and 50 MISs in skin with significant solar elastosis. The most valuable criteria for the diagnosis of MIS, as opposed to MH, were presence of nests of melanocytes, irregular distribution of melanocytes, descent of melanocytes far down adnexal epithelial structures, irregular distribution of pigment, presence of melanocytes above the junction, a high number of melanocytes, pleomorphism of melanocytes, and atypical nuclei of melanocytes. Other criteria, e.g., collapse of cytoplasm around nuclei of melanocytes; flattening of rete ridges; differences in the area, shape, and contour of nuclei of melanocytes as assessed by nuclear morphometry; and presence of melanocytes stained by HMB-45 and Ki-67/MIB-1 monoclonal antibodies, were found to be of low or no value for differential diagnosis.
Weyers
W
W
Center of Dermatology and Andrology, Hautklinik, Justus-Liebig University, Germany.
Bonczkowitz
M
M
Weyers
I
I
Bittinger
A
A
Schill
W B
WB
D000951:Antigens, Neoplasm / Q000032:analysis; D002280:Basal Cell Carcinoma / Q000473:pathology; D002452:Cell Count; D002467:Cell Nucleus / Q000648:ultrastructure; D004396:Coloring Agents; D003240:Connective Tissue Diseases / Q000473:pathology; D003593:Cytoplasm / Q000648:ultrastructure; D003937:Diagnosis, Differential; D004547:Elastic Tissue / Q000473:pathology; D004817:Epidermis / Q000473:pathology; D004848:Epithelium / Q000473:pathology; D006801:Humans; D006965:Hyperplasia; D007150:Immunohistochemistry; D019394:Ki-67 Antigen / Q000032:analysis; D008544:Melanocytes / Q000473:pathology*; D008545:Melanoma / Q000473:pathology*; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins / Q000032:analysis; D012680:Sensitivity and Specificity; D015595:Skin Aging; D012871:Skin Diseases / Q000473:pathology; D012878:Skin Neoplasms / Q000473:pathology*; D012880:Skin Pigmentation; D013472:Sunlight / Q000009:adverse effects*
D000951:Antigens, Neoplasm; D004396:Coloring Agents; D019394:Ki-67 Antigen; D058950:Melanoma-Specific Antigens; D009363:Neoplasm Proteins