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Mitotically Active Nevus and Nevoid Melanoma: A Clinicopathological and Molecular Study
Nima Mesbah Ardakani1,2,3, Shalinder Singh1, Carla Thomas1
1Department of Anatomical Pathology, PathWest Laboratory Medicine, QEII Medical Centre, Perth, WA, Australia.
The American Journal of Dermatopathology
|July 11, 2020
Summary
Distinguishing nevoid melanoma from mitotically active nevus is challenging. Cytogenetic testing and p16 immunohistochemistry can help differentiate these lesions, aiding diagnosis in difficult cases.
Area of Science:
- Dermatopathology
- Oncology
- Genetics
Background:
- Differentiating nevoid melanoma from mitotically active nevus is difficult microscopically.
- Accurate diagnosis is crucial for appropriate patient management.
Purpose of the Study:
- To identify reliable methods for distinguishing nevoid melanoma from mitotically active nevus.
- To compare clinicopathological features between these two entities.
Main Methods:
- Cytogenetic testing on 25 melanocytic proliferations.
- Clinicopathological analysis of 25 lesions classified by cytogenetics.
- Immunohistochemical analysis for p16 expression.
Main Results:
- Nevoid melanomas occurred in older patients and showed more deep mitoses, lack of maturation, and pseudo-maturation.
- Complete loss of p16 was observed in 70% of nevoid melanomas, correlating with CDKN2A gene loss.
- Chromosomal aberrations in nevoid melanomas resembled those in common melanoma subtypes.
Conclusions:
- Reproducible immunomorphological differences, particularly p16 loss, aid in distinguishing nevoid melanoma from mitotically active nevus.
- Cytogenetic analysis provides a valuable adjunct diagnostic tool for challenging lesions.
