Dermatopathologyp16 Expression: A marker of differentiation between childhood malignant melanomas and Spitz nevi
Section snippets
Patients
Six pathological formalin-fixed, paraffin-embedded skin biopsy specimens of patients with a diagnosis of Spitzoid nodular malignant melanoma made between 1998 and 2010 were obtained from the archives of the department of pathology of our tertiary care pediatric hospital. The childhood melanoma cases were all examined and confirmed by a minimum of two dermatopathologists. Spitzoid melanoma characteristically has higher degree of cytologic atypia than Spitz nevus.5 The most useful
Spitzoid nodular malignant melanoma
Patient age ranged between 3 and 14 years with a mean value of 8.67 years (SD = 4.18). Breslow thickness ranged between 1.22 and 5.58 mm with a mean value of 3.36 mm (SD = 1.75). Follow-up time ranged between 3 and 60 months with a mean value of 19.8 months (SD = 21.27). Ki-67 index ranged between 18% and 75% with a mean value of 48.5% (SD = 21.98). Mitotic count/mm2 ranged between 2 and 12 mitoses/mm2 with a mean value of 6.17 mitoses/mm2 (SD = 3.60).
All our childhood Spitzoid nodular
Discussion
p16 Has been shown to be essential for melanocyte senescence and found to be expressed in Spitz nevus and other types of benign melanocytic nevi.14, 15 This finding was corroborated in our series because all Spitz nevi and melanocytic nevi were positive for p16 staining. An analysis of cell cycle inhibitory proteins including p16, p21, and p27 showed that the majority of Spitz nevus cells expressed high levels of p16. Maldonado et al14 speculate that Spitz nevi and melanocytic nevi in general
References (24)
- et al.
Malignant melanoma in childhood and adolescence: a report of 13 cases
J Am Acad Dermatol
(2005) Spitzoid melanoma
Clin Dermatol
(2009)- et al.
MIB-1 monoclonal antibody to determine proliferative activity of Ki-67 antigen as an adjunct to the histopathologic differential diagnosis of Spitz nevi
J Am Acad Dermatol
(2001) - et al.
Spitz nevi and atypical Spitz nevi/tumors: a histologic and immunohistochemical analysis
Mod Pathol
(2005) - et al.
S100A6 protein expression is different in Spitz nevi and melanomas
Mod Pathol
(2003) - et al.
Expression of CD133+ cancer stem cells in childhood malignant melanoma and its correlation with metastasis
Mod Pathol
(2010) - et al.
Mechanisms of cell-cycle arrest in Spitz nevi with constitutive activation of the MAP-kinase pathway
Am J Pathol
(2004) - et al.
Alterations of p16 and p14ARF genes and their 9p21 locus in oral squamous cell carcinoma
Oral Surg Oral Med Oral Pathol Oral Radiol Endod
(2009) - et al.
Reduced expression of p16 and p27 is correlated with tumor progression in cutaneous melanoma
Pathology
(2007) - et al.
Childhood malignant melanoma: incidence and etiology
Am J Pediatr Hematol Oncol
(1985)
Spitzoid melanoma in children: clinicopathological study and application of immunohistochemistry as an adjunct diagnostic tool
J Cutan Pathol
Nevus Spitz–everlasting diagnostic difficulties–the review
Coll Antropol
Cited by (82)
Skin cancer biology and its biomarkers: Recent trends and prospective
2023, Biomarkers in Cancer Detection and Monitoring of Therapeutics: Diagnostic and Therapeutic Applications: Volume 2An Evidence-Based Approach to Pediatric Melanonychia
2022, Dermatologic ClinicsFaces of cellular senescence in skin aging
2021, Mechanisms of Ageing and DevelopmentPathology-based Biomarkers Useful for Clinical Decisions in Melanoma
2020, Archives of Medical ResearchCitation Excerpt :Complete loss of nuclear expression of p16 by IHC reportedly supports a diagnosis of different types of melanoma such as: desmoplastic (22), blue nevus-like (23), dermal (24), and is regarded as an indicator of poor prognosis (25,26). Homozygous deletion of p16 by FISH (which may be associated with loss of nuclear expression of p16 by IHC favors a diagnosis of Spitzoid melanoma over Spitz nevus (27). In addition, complete loss of expression of p16 by IHC, associated or not with copy number aberrations by FISH has been reported as highly specific for borderline and malignant Spitzoid neoplasms (28) (Figures 2A–2D).
Reflections of a lifetime in dermatopathology
2020, Diagnostic Histopathology
Funding sources: None.
Conflicts of interest: None declared.
Reprints not available from the authors.