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VS38 immunostaining in melanocytic lesions

J H Shanks¹, S S Banerjee

¹Department of Histopathology, Christie Hospital NHS Trust, Withington, Manchester.

Journal of Clinical Pathology

|March 1, 1996

Summary

The monoclonal antibody VS38, a marker for plasma cells, is frequently positive in malignant melanoma, including rare mucosal melanomas. This finding is crucial for diagnosing undifferentiated tumors, especially at unusual sites like the nasal cavity.

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Area of Science:

Oncology
Immunohistochemistry
Dermatopathology

Background:

The monoclonal antibody VS38 is a known marker for reactive/neoplastic plasma cells, aiding in diagnosing plasmacytoma, myeloma, and lymphomas.
A recent observation of a plasmacytoid melanoma showing strong VS38 immunoreactivity highlighted a potential diagnostic pitfall.

Purpose of the Study:

To investigate the immunoreactivity of VS38 in a spectrum of melanocytic lesions, both benign and malignant.
To assess the utility and potential diagnostic errors of VS38 in identifying tumor lineage, particularly in challenging cases.

Main Methods:

The study utilized the Streptavidin-peroxidase complex technique on 167 paraffin-embedded melanocytic lesions.
Chromogen selection (DAB or nickel/DAB) was adapted based on the pigmentation level of the lesions.

Main Results:

VS38 immunostaining was positive in 92% of primary cutaneous melanomas, 100% of primary mucosal melanomas, and 91.7% of recurrent/metastatic melanomas.
Positive staining was also observed in 14.5% of benign nevi (including Spitz nevi) and 10.5% of dysplastic nevi/in situ melanomas.
Clear cell sarcomas of soft tissues also showed 100% positivity.

Conclusions:

VS38 immunostaining is frequently positive in malignant melanoma, both primary and metastatic, and less commonly in benign nevi.
The results emphasize the importance of considering malignant melanoma in undifferentiated tumors with VS38 reactivity, especially those arising in unusual locations.
Clinicians should be aware of this potential diagnostic overlap when using VS38 for tumor lineage identification.

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