Pigmented squamous intraepithelial neoplasia of the anogenital area: a histopathological and immunohistochemical study of 64 specimens from 45 patients exploring the mechanisms of pigmentation.
Pigmented lesions in the anogenital area encompass a wide variety of disorders including squamous intraepithelial neoplasia. The authors sought to explore the mechanism(s) underlying clinically pigmented squamous intraepithelial neoplasia in the anogenital area. A light-microscopic and immunohistochemical study of 64 lesional specimens from 45 patients (32 women, 13 men; age range, 23-73 years) with pigmented lesions in the anogenital area was performed. Histopathologically, 63 (98%) specimens showed melanin incontinence into the superficial dermis beneath the dysplastic epithelium. A focal or total loss of basilar hyperpigmentation was detected in 30 (48%) and 13 (20%) of lesions, respectively. In 17 (27%) cases, absence of basal layer hyperpigmentation was accompanied by a subepithelial lichenoid infiltrate. Melanin within the upper part of dysplastic areas were seen in 63 cases (98%), whereas dendritic melanocytes colonization, mild in all but 1 specimen case, was observed in 53 (83%) cases. All cases proved to be the usual type of squamous intraepithelial neoplasia; no single case of the simplex (differentiated) variant was present. The main mechanisms of pigmented squamous intraepithelial neoplasia of the anogenital area include melanin incontinence and occurrence of melanin in dysplastic keratinocytes. Colonization of the dysplastic epithelium by dendritic melanocytes seems to contribute, but it is rarely a prominent feature.
*Sikl's Department of Pathology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; †Bioptical Laboratory, Pilsen, Czech Republic; ‡Department of Dermatology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; §Division of Dermatopathology, Albany Medical College, Albany, NY; ¶Department of Pathology, Fundación Jiménez Díaz, Universidad Autónoma, Madrid, Spain; ‖Department of Obstetrics and Gynecology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; **Department of Pathology, Clinical Oncological Scientific and Practical Centre for Specialized Medical Care, Saint Petersburg, Russia; ††Department of Dermatovenereology, Charles University in Prague, Faculty of Medicine in Pilsen, Pilsen, Czech Republic; and ‡‡Reprofit International, Clinic of Reproductive Medicine and Gynecology, Brno, Czech Republic.
Denisa
D
Kacerovska
Luis
L
Requena
J Andrew
JA
Carlson
Carlos
C
Santonja
Michal
M
Michal
Jiri
J
Bouda
Anastasia M
AM
Konstantinova
Jana
J
Kaspirkova
Tomas
T
Fikrle
Leopold
L
Rotter
Dmitry V
DV
Kazakov
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001005:Anus Neoplasms / Q000473:pathology*; D002278:Carcinoma in Situ / Q000473:pathology*; D005260:Female; D005833:Genital Neoplasms, Female / Q000473:pathology*; D005834:Genital Neoplasms, Male / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D017403:In Situ Hybridization; D008297:Male; D008543:Melanins; D008544:Melanocytes / Q000473:pathology; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012880:Skin Pigmentation; D055815:Young Adult
D008543:Melanins