PRAME Immunohistochemistry for Differentiating Pigmented Lesions of the Vulva and Perineum

IF 1.1 4区 医学 Q3 DERMATOLOGY
Kasey J. McCollum, Maria Angelica Selim, Michelle Schneider
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Abstract

Special site pigmented lesions often present a diagnostic challenge for clinicians and for pathologists. Lesions of the genital region present even further challenges due to the sensitivity of the anatomic location and preference to defer physical exam and biopsy. Even after biopsy, the diagnostic challenge persists owing to the frequent presence of atypical features in these sites and the technical difficulties associated with performing complete excisions. Immunohistochemistry plays a crucial role in the classification and categorization of these lesions. PRAME (PReferentially expressed Antigen in MElanoma) is a nuclear receptor and transcriptional regulator that regulates cell differentiation, growth, and apoptosis. Immunohistochemistry for PRAME has proven valuable in assisting pathologists to classify various cutaneous melanocytic proliferations all over the human body. Our study sought to investigate the use of PRAME in determining the biologic nature of pigmented lesions of the genital region. A search of medical records identified 53 cases of genital pigmented lesions for review. Each case received MART1 and PRAME IHC for evaluation and classification by two board certified dermatopathologists. The results found that PRAME was negative (zero nuclear staining) in a total of 32 benign lesions (i.e., melanosis including macules and lentigos as well as nevi). One dysplastic nevus showed focal weak PRAME expression in less than 10% of lesional melanocytes. PRAME was overwhelmingly positive (4+ staining, > 75% of nuclei) in 90% of the malignant lesions (i.e., invasive melanoma and melanoma in situ). Overall, we conclude that PRAME remains a valuable tool in the diagnostic workup of diagnosing pigmented lesions of the genital region.

PRAME免疫组织化学鉴别外阴和会阴色素病变。
对于临床医生和病理学家来说,特殊部位的色素病变往往是诊断上的挑战。由于解剖位置的敏感性和推迟体格检查和活检的偏好,生殖器区域的病变提出了进一步的挑战。即使在活检后,由于这些部位经常出现非典型特征以及进行完全切除相关的技术困难,诊断挑战仍然存在。免疫组织化学在这些病变的分类和分类中起着至关重要的作用。PRAME(黑色素瘤中的优先表达抗原)是一种核受体和转录调节剂,可调节细胞分化、生长和凋亡。PRAME的免疫组织化学已被证明在帮助病理学家对人体各种皮肤黑色素细胞增生进行分类方面有价值。我们的研究旨在调查PRAME在确定生殖区域色素病变的生物学性质中的应用。对医疗记录的搜索确定了53例生殖器色素病变进行审查。每个病例接受MART1和PRAME IHC,由两名委员会认证的皮肤病理学家进行评估和分类。结果发现,在32个良性病变(即包括斑疹、小痣和痣在内的黑色素病)中PRAME为阴性(零核染色)。一例发育不良痣在不到10%的病灶黑色素细胞中显示局灶性弱PRAME表达。PRAME在90%的恶性病变(即侵袭性黑色素瘤和原位黑色素瘤)中呈压倒性阳性(4+染色,75%的核呈>)。总的来说,我们得出结论,PRAME仍然是诊断生殖器区域色素病变的诊断工作中有价值的工具。
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来源期刊
CiteScore
3.20
自引率
5.90%
发文量
174
审稿时长
3-8 weeks
期刊介绍: Journal of Cutaneous Pathology publishes manuscripts broadly relevant to diseases of the skin and mucosae, with the aims of advancing scientific knowledge regarding dermatopathology and enhancing the communication between clinical practitioners and research scientists. Original scientific manuscripts on diagnostic and experimental cutaneous pathology are especially desirable. Timely, pertinent review articles also will be given high priority. Manuscripts based on light, fluorescence, and electron microscopy, histochemistry, immunology, molecular biology, and genetics, as well as allied sciences, are all welcome, provided their principal focus is on cutaneous pathology. Publication time will be kept as short as possible, ensuring that articles will be quickly available to all interested in this speciality.
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