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Related Experiment Videos

Malignant melanoma with paradoxical maturation.

S M Ruhoy1, V G Prieto, S L Eliason

  • 1Department of Pathology, Duke University Medical Center, Durham, North Carolina 27710, USA.

The American Journal of Surgical Pathology
|December 16, 2000
PubMed
Summary

This study identifies invasive melanomas with paradoxical maturation (IMPs) that mimic benign nevi. IMPs present diagnostic challenges, requiring specific histologic, morphometric, and immunohistochemical criteria for accurate melanoma diagnosis.

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Area of Science:

  • Dermatopathology
  • Oncology
  • Histology

Background:

  • Melanocytic nevi typically mature with depth, showing smaller cells.
  • Most conventional malignant melanomas (MMs) lack maturation and display large, pleomorphic cells.
  • A subset of melanomas exhibits paradoxical maturation, mimicking benign nevi.

Purpose of the Study:

  • To describe and differentiate invasive melanomas with paradoxical maturation (IMPs) from conventional MMs and compound nevi (CN).
  • To establish diagnostic criteria for IMPs to avoid misdiagnosis.

Main Methods:

  • Histologic, cytomorphometric, and immunohistochemical analysis of 17 IMPs, 2 epidermotropic metastatic melanomas with maturation (EMMMs), 13 CN, and 14 conventional MMs.
  • Evaluation of nuclear/cellular areas, Ki-67, glycoprotein (gp)100, and tyrosinase expression at different dermal depths.

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Main Results:

  • IMPs showed decreased nuclear/cellular areas and reduced Ki-67, gp100, and tyrosinase expression with depth, similar to CN.
  • IMPs differed from conventional MMs by having smaller deep areas and reduced superficial/deep Ki-67, deep gp100, and deep tyrosinase.
  • IMPs differed from CN by exhibiting larger areas, more confluence, increased mitotic figures, higher Ki-67 and gp100 expression, and more melanin.

Conclusions:

  • Invasive melanomas with paradoxical maturation (IMPs) can mimic benign nevi, posing a diagnostic hazard.
  • Histologic, morphometric, and immunohistochemical criteria are proposed to aid in the accurate diagnosis of IMPs.
  • Epidermotropic metastatic melanomas with maturation (EMMMs) share features with primary IMPs.