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Pagetoid infiltration in primary cutaneous melanoma
1Department of Histopathology, St George's Hospital Medical School, London, UK.
Histopathology
|May 1, 1992
Summary
Pagetoid infiltration, or buckshot spread, of melanocytes in the epidermis is not always present in cutaneous melanoma. Its absence should not prevent a melanoma diagnosis, as it was found in less than half of cases studied.
Area of Science:
- Dermatopathology
- Oncology
- Histopathology
Background:
- Pagetoid infiltration by melanocytes is considered by some to be essential for diagnosing primary cutaneous melanoma.
- The frequency and diagnostic significance of pagetoid infiltration require further investigation.
Purpose of the Study:
- To determine the frequency of pagetoid infiltration in cutaneous melanoma.
- To assess the relationship between pagetoid infiltration and other histopathological features of melanoma.
Main Methods:
- Retrospective review of 340 melanoma cases over 23 years.
- Histopathological analysis to identify and quantify pagetoid infiltration.
- Correlation analysis with tumor thickness, invasion level, growth phase, mitotic count, regression, and other features.
Main Results:
- Conspicuous pagetoid infiltration was observed in 32.1% of melanomas.
- Occasional pagetoid melanocytes were present in 23.5% of cases; absent in 44.4%.
- Pagetoid infiltration correlated inversely with tumor thickness and positively with regression, common in thin melanomas.
Conclusions:
- Pagetoid infiltration is not consistently present in cutaneous melanoma, being most common in early-stage lesions.
- The absence of pagetoid infiltration should not exclude a diagnosis of melanoma.
- Histopathological features like tumor thickness and regression are more reliable indicators than pagetoid spread alone.