The Melanocytic Proliferations E-Book

A. Neil Crowson

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1391

Veröffentlichungsjahr: 2014

Beschreibung

A thorough updating of the best-selling, vital reference and textbook on melanocytic proliferations PRAISE FOR THE FIRST EDITION: "Well-written and entertaining" --Modern Pathology "An extremely helpful guide for the practicing dermatopathologist or general pathologist" --Archives of Pathology and Laboratory Medicine "An incredibly relevant clinical-histopathologic text" --Doody's Melanocytic proliferations comprise a large number of pigmented lesions of the skin and muscosa. Of these, melanoma is of particular interest to clinicians and their patients. The rising number of incidences of melanoma has led to increased interest in the disease from diagnostic, management, and basic science perspectives. The Melanocytic Proliferations: A Comprehensive Textbook of Pigmented Lesions is the most complete single-source treatment of the subject available--thoroughly updated to reflect the very latest studies and clinical experience in diagnosing and treating melanocytic proliferation. This new edition of the bestseller presents an experience- and evidence-based review of pigmented lesions that encompasses the biology, diagnosis, and treatment of melanocytic proliferations and disorders, including melanoma. It comes with over 300 new color images--bringing the total to over 600--and contains two completely new chapters: Dermatoscopic Diagnosis of Melanoma; and Reflectance Confocal Microscopy. Chapter coverage includes: * An approach to the clinical diagnosis of melanoma, its precursors, and its clinical mimics * Freckles and lentigines * Benign acquired nevi * Dermal dendritic melanocytic proliferations/dermal melanocytoses * Spitz nevus * Combined nevus, deep penetrating nevus, plexiform spindle cell nevus, and borderline tumors of the deep penetrating nevus variant * Recurrent melanocytic nevus * Congenital nevi * Dysplastic melanocytic nevi, de novo intradermal epithelioid and lentiginous melanocytic dysplasias, and nevi at specific anatomic sites * Melanoma * Conjunctival melanocytic proliferations * Use of adjunctive immunoperoxidase, molecular, and ultrastructural studies in the diagnosis of melanocytic proliferations * Biology of melanoma * Borderline melanocytic proliferation * Dermatoscopic diagnosis of melanoma * Reflectance confocal microscopy * Therapy of melanoma The Melanocytic Proliferations: A Comprehensive Textbook of Pigmented Lesions is an incredibly important text for all clinical pathologists, dermatopathologists, surgical pathologists, dermatologists, cosmetic physicians, and surgeons.

Leseprobe

Table of Contents

Title page

Copyright page

Dedication

Preface

Disclosure

About the Companion Website

Chapter 1: An Approach to the Clinical Diagnosis of Melanoma, Its Precursors, and Its Clinical Mimics

Introduction

Incidence and risk

Precursors to melanoma

Approach to the patient

Summary

Atlas of Clinical Lesions Correlating to Various Entities Discussed in the Text

Chapter 2: Freckles and Lentigines

Chapter 3: Benign Acquired Nevi

Chapter 4: Dermal Dendritic Melanocytic Proliferations/Dermal Melanocytoses

Chapter 5: Spitz Nevus

Chapter 6: Combined Nevus, Deep Penetrating Nevus, and Plexiform Spindle Cell Nevus

Chapter 7: Recurrent Melanocytic Nevus

Chapter 8: Congenital Nevi

Chapter 9: Dysplastic Melanocytic Nevi, De Novo Intraepidermal Epithelioid and Lentinginous Melanocytic Dysplasias, and Nevi at Specific Anatomic Sites

Chapter 10: Melanoma

Chapter 11: Conjunctival Melanocytic Proliferations

Chapter 2: Freckles and Lentigines

Freckles (ephelides)

Dowling–Degos disease

Lentigines: Lentigo simplex and the lentiginoses

Mucosal lentigines

Actinic (solar) lentigo

Pigmented actinic keratosis

PUVA-induced lentigines (PUVA therapy/tanning beds/xeroderma pigmentosum)

Large cell acanthoma

Becker nevus

Ink spot lentigo

Melasma

Albright syndrome

The café-au-lait macule

Postinflammatory hyperpigmentation

Chapter 3: Benign Acquired Nevi

Broad overview of clinical features of the common acquired nevus

Broad overview of the histologic features of the common acquired nevus

Histopathology of the common acquired junctional nevus

Histopathology of the common acquired compound nevus

Histopathology of the common acquired dermal nevus

Other acquired benign nevi

Problematic topics in the realm of the common acquired nevus

Chapter 4: Dermal Dendritic Melanocytic Proliferations/Dermal Melanocytoses

Introduction

Common blue nevus of Jadassohn–Tieche

Epithelioid blue nevus

Cellular blue nevus

Nevi of Ota and Ito

Mongolian spot

Sun's nevus

Dermal melanocyte hamartoma

Chapter 5: Spitz Nevus

Introduction

Classical compound Spitz nevus

Dermal Spitz nevus and its nonmelanocytic mimics: neurothekeoma, epithelioid cell histiocytoma, plexiform fibrohistiocytic tumor, and epithelioid angiosarcoma

Sclerosing or desmoplastic Spitz nevus/desmoplastic nevus

Pagetoid intraepidermal Spitz nevus

Pigmented spindle cell nevus

Pigmented epithelioid cell nevus

Superficial atypical Spitz tumor/plaque-type Spitz nevus

Conventional deep variant of the atypical Spitz tumor

Molecular and immunohistochemical studies as an adjunct to diagnosis of Spitz nevus

Chapter 6: Combined Nevus, Deep Penetrating Nevus, Plexiform Spindle Cell Nevus, and Borderline Tumors of the Deep Penetrating Nevus Variant

Combined nevus

Deep penetrating nevus

Plexiform spindle cell nevus

Borderline tumor with deep penetrating nevus-like features

Chapter 7: Recurrent Melanocytic Nevus

Introduction and clinical features

Histopathology

Differentiation from melanoma with regression and recurrent melanoma

Grading atypia in recurrent nevi

Chapter 8: Congenital Nevi

Introduction and clinical features

Histology

Proliferative nodules in congenital nevi

Treatment

Molecular profile

Chapter 9: Dysplastic Melanocytic Nevi, De Novo Intradermal Epithelioid and Lentiginous Melanocytic Dysplasias, and Nevi at Specific Anatomic Sites

Dysplastic melanocytic nevus

Incipient junctional dysplastic nevus/de novo melanocytic dysplasia of lentiginous type/atypical lentigenous melanocytic hyperplasia with architectural features of dysplastic nevus

Immunohistochemical stains as a diagnostic adjunct

Nevomelanocytic proliferations peculiar to specific anatomic sites

Histopathology

Chapter 10: Melanoma

Introduction

Specific subtypes of melanoma

Lentiginous melanoma

Vertical growth phase of melanoma

Prognostication including microstaging of melanoma

Survival based on tumor thickness for melanoma

Unusual histologic and clinical variants of melanoma

Chapter 11: Conjunctival Melanocytic Proliferations

Introduction

Primary acquired melanosis

Nevi of the conjunctiva and eyelid skin

Conjunctival melanoma

Chapter 12: Use of Adjunctive Immunoperoxidase, Molecular, and Ultrastructural Studies in the Diagnosis of Melanocytic Proliferations

Introduction

The melanosome/premelanosome associated antigenic markers: gp100, Melan-A/Mart-1, tyrosinase, MAGE-1/3, and gp75

Additional novel immunohistochemical stains as a diagnostic adjunct

Role of molecular adjuncts in melanoma diagnosis

Fluorescence in situ hybridization (FISH)

Role of the electron microscope in melanoma diagnosis

Chapter 13: Biology of Melanoma

Introduction

Recent advances in the molecular basis of melanomagenesis and its clinical correlation

Current concept in oncogenesis and tumor suppression in melanomagenesis and clinical correlation

Melanoma stem cell

Genetic basis of melanoma: cell cycle dysregulation and the malignant phenotype

p53, bcl-2, Fas, telomerases, and the apoptotic pathways

Oncogenes and proto-oncogenes

Markers of cell proliferative activity

Growth factor interdependence and regulatory pathways in melanoma

Cell–matrix interactions in melanoma progression

Cytoskeletal components, invasion, and the metastatic pathway

Matrix metalloproteinases

p75 nerve growth factor receptor

Angiogenesis and the metastatic phenotype

Immune response to melanoma

Chapter 14: Borderline Melanocytic Proliferation

Introduction

Superficial borderline melanocytic proliferations

Deeper dermal and or compound borderline melanocytic proliferations

Summary

Chapter 15: Dermatoscopic Diagnosis of Melanoma

Clinical diagnosis without devices

Defining a gold standard

Limitations of technology

Rationale for dermoscopy algorithms

Clinical utilization: a pragmatic tool

Clinical practice: work flow

Clinical diagnosis: examples

Acknowledgement

Chapter 16: Reflectance Confocal Microscopy

Introduction

Patterns of melanocytic lesions

Lentigo maligna

Therapeutic monitoring

Pigmented basal cell carcinoma

Clinical workflow

Acknowledgement

Chapter 17: Therapy of Melanoma

Surgical therapy

Sentinel lymph node biopsy

Surgical and pathologic procedures

Adjuvant therapy of melanoma

Therapy of metastatic melanoma

Biologic response modifiers and immunotherapy

Specific immunization, including vaccination strategies

Radiation therapy

Therapy of lentigo maligna

Therapy of head and neck cutaneous and mucosal melanoma

Cerebral metastasis therapy with radiation

Index

Copyright © 2014 by John Wiley & Sons, Inc. All rights reserved

Published by John Wiley & Sons, Inc., Hoboken, New Jersey

Published simultaneously in Canada

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Library of Congress Cataloging-in-Publication Data:

Crowson, A. Neil.

The melanocytic proliferations : a comprehensive textbook of pigmented lesions / A. Neil Crowson, Cynthia M. Magro, Martin C. Mihm, Jr. – 2nd ed.

p. ; cm.

Includes bibliographical references and index.

ISBN 978-0-470-56155-3 (hardback : alk. paper) – ISBN 978-1-118-48893-5 – ISBN 978-1-118-48894-2 (mobi) – ISBN 978-1-118-48895-9 (pdf) – ISBN 978-1-118-48896-6 (pub)

I. Magro, Cynthia M. II. Mihm, Martin C., 1934– III. Title.

[DNLM: 1. Melanoma. 2. Skin Neoplasms. 3. Melanocytes–pathology. 4. Nevus. WR 500]

RC280.M37

616.99'477–dc23

2013007100

Cover image: iStock file #8099914 © DPhoto

Cover design by Matt Kuhns

Dedication

This book is respectfully dedicated to the memory of Doctor Ramzi Cotran,

to those like him who have died or will die from melanoma, and to themen and women who toil to lift this scourge from the brow of mankind.

Preface

Much has occurred in the field of molecular biology since the first edition of this book was published in 2001. Ruifeng Guo, MD, PhD, a resident in the Pathology Department of the University of Oklahoma, has made an important contribution in revising the chapter on biology in this edition. Only as these technologies are applied in the clinical arena are we finding discordance between genomic hybridization and fluorescence in situ hybridization studies on the one hand and morphology and biologic behavior on the other. To our surprise, morphology frequently seems to hold the trump card in predicting behavior. Our suspicions regarding the molecular biopsy of melanoma are two-fold: first, that melanoma is plastic from a molecular perspective, and that the genome of the cancer cell is in flux during disease evolution; and second, that a revolution in the treatment of metastatic melanoma must be based upon a more comprehensive understanding of the afore-stated molecular biology. We believe that histomorphology will continue to be the cornerstone of diagnosis and management for the foresee­able future.

Confocal microscopy has emerged, and the use of dermoscopy has become widespread, in the last decade. Accordingly, we include two new chapters to address these important areas. The former chapter was written by Dr R Condon Hughes of the Diagnostic Tissue/Cytology Group of Meridian, MS, and by Christi Alessi-Fox, Director of Clinical Activities for Lucid Technologies in Rochester, NY. Mitchell A. Kline MD, Clinical Assistant Professor of Dermatology at Cornell University Medical College Weill NY-Presbyterian Medical Center has written the chapter on dermoscopy with the assistance of Jennifer Ostroff, BA. Dr Kline provides an exhaustive atlas of vignettes available through a web-based application open to those who have purchased this textbook. We are indebted to our co-authors for these contributions.

A. Neil Crowson

Cynthia M. Magro

Martin C. Mihm, Jr.

Disclosure

Dr Cynthia Magro is a co-founder of CEPbiotech, a company with exclusive license to distribute anti-sAC antibodies.

About the Companion Website

This book is accompanied by a companion website:

www.wiley.com/go/crowson/melanocyticproliferations

The website includes:

Case vignettes

Chapter 1

An Approach to the Clinical Diagnosis of Melanoma, Its Precursors, and Its Clinical Mimics

Introduction

Before the 1960s, melanoma was considered a single, monotypic disease with an ominous prognosis. It was during this decade that systematic study of patients with melanoma first began at the Massachusetts General Hospital (MGH) in Boston, Massachusetts, and at the Royal Prince Alfred Hospital in Sydney, Australia. The opportunity to systematically analyze large patient series flowed directly from the establishment of focused multidisciplinary clinics, of which the seminal example is the Pigmented Lesion Clinic of Massachusetts General Hospital founded by Drs Wallace H. Clark, Thomas B. Fitzpatrick, Martin C. Mihm, Jr, and John W. Raker on April 6, 1966. A primary goal of this clinic was to emphasize clinical diagnosis and to correlate clinical findings directly to histopathology. It was thus that Dr Fitzpatrick was first able to recognize the implication of, and to draw attention to, variegations in the color and border mor­phology of melanocytic neoplasms (Fitzpatrick and Clark, 1964). As a direct result of these clinical and histopathologic studies, melanoma was shown to be a disease with several distinct subtypes (Clark et al., 1969; McGovern, 1970). Features of early diagnosis gleaned from systematic analytic methods were published in an atlas of pigmented lesions (Mihm et al., 1973) that was widely distributed. The formation of the Melanoma Clinical Cooperative Group, which included the Pigmented Lesion Clinic at the Massachusetts General Hospital and the subsequently formed pigmented lesion clinics of New York University, Temple University in Philadelphia, and the University of California at San Francisco, led to fruitful clinical, epidemiologic, pathologic, and prognostic studies of nevi and of melanoma and its precursors. Among the many contributions that came out of this group effort was an appreciation of the diagnostic features by the clinical practitioner, as encompassed by the mnemonic: “A, B, C, and Ds” of melanoma diagnosis (Friedman et al., 1985), as well as:

1. The addition of acral lentiginous melanoma to the classification scheme.

2. The studies that led to the recognition of a variety of clinical and pathologic factors in prognosis based on multivariate analysis of a variety of different attributes.

3. The recognition of microscopic satellites as a prognostic factor and as a predictor of microscopic deposits of melanoma in clinically negative draining lymph nodes.

4. The recognition, at the University of Pennsylvania Pigmented Lesion Clinic, of the dysplastic nevus and of familial clusters that expressed both multiple dysplastic nevi and melanoma.

The references for this chapter cite merely a fraction of the published contributions that flowed from the many studies that subsequently came from a group led by Drs. T. B. Fitzpatrick, W. H. Clark, A. W. Kopf, S. Blois, and A. J. Sober, who directed the effort for 6 years at their institutions, and their teams of dermatologists, surgeons, oncologists, epidemiologists, statisticians, pathologists, and basic scientists (Day et al., 1982a–d, 1983; Harrist et al., 1984). Pigmented lesion clinics are now active in many centers in the United States and throughout the world, coordinating the scientific study of this complex and deadly neoplasm, its precursors, its epidemiologic features, its treatment and basic research into its biology. With respect to the latter, recognition of a heredofamilial basis for some cases of melanoma and its precursors was a key event in the history of clinical oncology and one that led indirectly to the Human Genome Project, which will, ultimately, have the most profound impact on medicine and the science of human genomics.

Incidence and risk

The remarkable increase in the incidence of melanoma has led to increased interest in the disease from diagnostic, management, and basic science perspectives. In 1935 the risk of developing melanoma in the United States was roughly 1 in 1500. The risk is closer to 1 in 87 in the modern era. This is a worldwide phenomenon (Pizzaro Redondo et al., 1998).

Analysis of the risk of developing melanoma helps to identify those individuals who must be more closely examined and followed. One of the most important risk factors is the presence of a changing mole, which is associated with a higher probability of melanoma, emphasizing the importance of self-examination so as to facilitate prompt presentation to a physician for evaluation. Certainly, the presence of many nevi is in itself a risk factor and necessitates follow-up. The risk associated with dysplastic nevi rises according to the number of dysplastic nevi present in a given patient, the presence of a prior melanoma, and a family history of dysplastic nevi and melanoma. A patient who has multiple dysplastic nevi, a prior history of melanoma, and a family history of melanoma may have a risk several hundredfold higher than a person without these characteristics. Siblings with dysplastic nevi in the setting of familial melanoma have a very high lifetime risk of developing melanoma if another sibling similarly affected develops melanoma (Greene et al., 1985). A person with a single dysplastic nevus without any history of melanoma in the family may have a several-fold increased risk of melanoma compared with someone who has no dysplastic nevi. In contrast, a history of sun sensitivity or multiple blistering sunburns does not, in isolation, confer more than a three- or four-fold increase in risk compared with persons without these factors. Risk has been discussed by several authors in several series and varies according to the series (Lewis and Johnson, 1968; Rhodes and Melski, 1982; Doherty and MacKie, 1986; Rhodes et al., 1987; Rigel et al., 1988, 1989; Garbe et al., 1989; Grob et al., 1990; Rhodes, 1994). The striking variation in the number of melanomas associated with nevi deserves comment. Series have been reported with incidences varying from 15% to 85% (Stadler and Garbe, 1990; Elder et al., 1981). In patients with dysplastic nevi, as many as 70% or more of melanomas arise in association with precursor dysplastic nevi (Elder et al., 1981). A striking association between plantar nevi and melanoma was observed decades ago (Lewis and Johnson, 1968).