Melanocytic nevus pathophysiology: Difference between revisions
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===Congenital melanocytic nevi (CMN)=== | ===Congenital melanocytic nevi (CMN)=== | ||
*Congenital melanocytic nevi (CMN) are hamartomas lesions. | |||
*When melanocytic nevi are present at birth or within the first few months of life they are known as Congenital melanocytic nevi (CMN). | |||
*Congenital melanocytic nevi (CMN) are hamartomas lesions. | |||
*Small melanocytic nevi that appear during early childhood between three months and two years of age, resemble true CMN clinicaly and histologicaly and are known as "tardive CMN," "early-onset nevi," and "congenital nevus-like nevi.<ref name="pmid12130901">{{cite journal |vauthors=Makkar HS, Frieden IJ |title=Congenital melanocytic nevi: an update for the pediatrician |journal=Curr. Opin. Pediatr. |volume=14 |issue=4 |pages=397–403 |date=August 2002 |pmid=12130901 |doi= |url=}}</ref> | |||
*During embryogenesis clonal proliferations of benign melanocytes may give rise to melanocytic nevi.<ref name="pmid15692463">{{cite journal |vauthors=Tannous ZS, Mihm MC, Sober AJ, Duncan LM |title=Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management |journal=J. Am. Acad. Dermatol. |volume=52 |issue=2 |pages=197–203 |date=February 2005 |pmid=15692463 |doi=10.1016/j.jaad.2004.07.020 |url=}}</ref><ref name="pmid20541682">{{cite journal |vauthors=Price HN, Schaffer JV |title=Congenital melanocytic nevi-when to worry and how to treat: Facts and controversies |journal=Clin. Dermatol. |volume=28 |issue=3 |pages=293–302 |date=2010 |pmid=20541682 |doi=10.1016/j.clindermatol.2010.04.004 |url=}}</ref> | *During embryogenesis clonal proliferations of benign melanocytes may give rise to melanocytic nevi.<ref name="pmid15692463">{{cite journal |vauthors=Tannous ZS, Mihm MC, Sober AJ, Duncan LM |title=Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management |journal=J. Am. Acad. Dermatol. |volume=52 |issue=2 |pages=197–203 |date=February 2005 |pmid=15692463 |doi=10.1016/j.jaad.2004.07.020 |url=}}</ref><ref name="pmid20541682">{{cite journal |vauthors=Price HN, Schaffer JV |title=Congenital melanocytic nevi-when to worry and how to treat: Facts and controversies |journal=Clin. Dermatol. |volume=28 |issue=3 |pages=293–302 |date=2010 |pmid=20541682 |doi=10.1016/j.clindermatol.2010.04.004 |url=}}</ref> | ||
*BRAF V600E mutations have a very high corelation with small congenital melanocytic nevi (CMN), acquired melanocytic nevi and cutaneous melanomas.<ref name="pmid16691193">{{cite journal |vauthors=Ichii-Nakato N, Takata M, Takayanagi S, Takashima S, Lin J, Murata H, Fujimoto A, Hatta N, Saida T |title=High frequency of BRAFV600E mutation in acquired nevi and small congenital nevi, but low frequency of mutation in medium-sized congenital nevi |journal=J. Invest. Dermatol. |volume=126 |issue=9 |pages=2111–8 |date=September 2006 |pmid=16691193 |doi=10.1038/sj.jid.5700366 |url=}}</ref><ref name="pmid18032947">{{cite journal |vauthors=Wu J, Rosenbaum E, Begum S, Westra WH |title=Distribution of BRAF T1799A(V600E) mutations across various types of benign nevi: implications for melanocytic tumorigenesis |journal=Am J Dermatopathol |volume=29 |issue=6 |pages=534–7 |date=December 2007 |pmid=18032947 |doi=10.1097/DAD.0b013e3181584950 |url=}}</ref> | *BRAF V600E mutations have a very high corelation with small congenital melanocytic nevi (CMN), acquired melanocytic nevi and cutaneous melanomas.<ref name="pmid16691193">{{cite journal |vauthors=Ichii-Nakato N, Takata M, Takayanagi S, Takashima S, Lin J, Murata H, Fujimoto A, Hatta N, Saida T |title=High frequency of BRAFV600E mutation in acquired nevi and small congenital nevi, but low frequency of mutation in medium-sized congenital nevi |journal=J. Invest. Dermatol. |volume=126 |issue=9 |pages=2111–8 |date=September 2006 |pmid=16691193 |doi=10.1038/sj.jid.5700366 |url=}}</ref><ref name="pmid18032947">{{cite journal |vauthors=Wu J, Rosenbaum E, Begum S, Westra WH |title=Distribution of BRAF T1799A(V600E) mutations across various types of benign nevi: implications for melanocytic tumorigenesis |journal=Am J Dermatopathol |volume=29 |issue=6 |pages=534–7 |date=December 2007 |pmid=18032947 |doi=10.1097/DAD.0b013e3181584950 |url=}}</ref> | ||
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*Compared to acquired melanocytic nevi, CMN penetrate into deeper layers of dermis.<ref name="pmid4756859">{{cite journal |vauthors=Mark GJ, Mihm MC, Liteplo MG, Reed RJ, Clark WH |title=Congenital melanocytic nevi of the small and garment type. Clinical, histologic, and ultrastructural studies |journal=Hum. Pathol. |volume=4 |issue=3 |pages=395–418 |date=September 1973 |pmid=4756859 |doi= |url=}}</ref> | *Compared to acquired melanocytic nevi, CMN penetrate into deeper layers of dermis.<ref name="pmid4756859">{{cite journal |vauthors=Mark GJ, Mihm MC, Liteplo MG, Reed RJ, Clark WH |title=Congenital melanocytic nevi of the small and garment type. Clinical, histologic, and ultrastructural studies |journal=Hum. Pathol. |volume=4 |issue=3 |pages=395–418 |date=September 1973 |pmid=4756859 |doi= |url=}}</ref> | ||
*Melanocytes in CMN follow pathyway of nerves and vessels and grow along adenxal structures (eg, hair follicles, sebaceous glands, eccrine ducts) and settle between collagen bundles in a single arrangement.<ref name="pmid6715623">{{cite journal |vauthors= |title=Precursors to malignant melanoma. National Institutes of Health Consensus Development Conference Statement, Oct. 24-26, 1983 |journal=J. Am. Acad. Dermatol. |volume=10 |issue=4 |pages=683–8 |date=April 1984 |pmid=6715623 |doi= |url=}}</ref><ref name="pmid22771898">{{cite journal |vauthors=Kokta V, Hung T, Al Dhaybi R, Lugassy C, Barnhill RL |title=High prevalence of angiotropism in congenital melanocytic nevi: an analysis of 53 cases |journal=Am J Dermatopathol |volume=35 |issue=2 |pages=180–3 |date=April 2013 |pmid=22771898 |doi=10.1097/DAD.0b013e318260908c |url=}}</ref> | *Melanocytes in CMN follow pathyway of nerves and vessels and grow along adenxal structures (eg, hair follicles, sebaceous glands, eccrine ducts) and settle between collagen bundles in a single arrangement.<ref name="pmid6715623">{{cite journal |vauthors= |title=Precursors to malignant melanoma. National Institutes of Health Consensus Development Conference Statement, Oct. 24-26, 1983 |journal=J. Am. Acad. Dermatol. |volume=10 |issue=4 |pages=683–8 |date=April 1984 |pmid=6715623 |doi= |url=}}</ref><ref name="pmid22771898">{{cite journal |vauthors=Kokta V, Hung T, Al Dhaybi R, Lugassy C, Barnhill RL |title=High prevalence of angiotropism in congenital melanocytic nevi: an analysis of 53 cases |journal=Am J Dermatopathol |volume=35 |issue=2 |pages=180–3 |date=April 2013 |pmid=22771898 |doi=10.1097/DAD.0b013e318260908c |url=}}</ref> | ||
* | |||
===Gross Pathology=== | ===Gross Pathology=== | ||
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Editors-In-Chief: Martin I. Newman, M.D., FACS, Cleveland Clinic Florida, [1];Associate Editor(s)-in-Chief: Qurrat-ul-ain Abid, M.D.[2] Michel C. Samson, M.D., FRCSC, FACS [3]
Overview
Melanocytic nevus is a benign growth on the skin (usually tan, brown, or flesh-colored) that contains a cluster of melanocytes and surrounding supportive tissue.
Pathophysiology
Congenital melanocytic nevi (CMN)
- When melanocytic nevi are present at birth or within the first few months of life they are known as Congenital melanocytic nevi (CMN).
- Congenital melanocytic nevi (CMN) are hamartomas lesions.
- Small melanocytic nevi that appear during early childhood between three months and two years of age, resemble true CMN clinicaly and histologicaly and are known as "tardive CMN," "early-onset nevi," and "congenital nevus-like nevi.[1]
- During embryogenesis clonal proliferations of benign melanocytes may give rise to melanocytic nevi.[2][3]
- BRAF V600E mutations have a very high corelation with small congenital melanocytic nevi (CMN), acquired melanocytic nevi and cutaneous melanomas.[4][5]
- While giant congenital melanocytic nevi (CMN) have somatic gain-of-function mutations in NRAS.[6][7]
- Compared to acquired melanocytic nevi, CMN penetrate into deeper layers of dermis.[8]
- Melanocytes in CMN follow pathyway of nerves and vessels and grow along adenxal structures (eg, hair follicles, sebaceous glands, eccrine ducts) and settle between collagen bundles in a single arrangement.[9][10]
Gross Pathology
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References
- ↑ Makkar HS, Frieden IJ (August 2002). "Congenital melanocytic nevi: an update for the pediatrician". Curr. Opin. Pediatr. 14 (4): 397–403. PMID 12130901.
- ↑ Tannous ZS, Mihm MC, Sober AJ, Duncan LM (February 2005). "Congenital melanocytic nevi: clinical and histopathologic features, risk of melanoma, and clinical management". J. Am. Acad. Dermatol. 52 (2): 197–203. doi:10.1016/j.jaad.2004.07.020. PMID 15692463.
- ↑ Price HN, Schaffer JV (2010). "Congenital melanocytic nevi-when to worry and how to treat: Facts and controversies". Clin. Dermatol. 28 (3): 293–302. doi:10.1016/j.clindermatol.2010.04.004. PMID 20541682.
- ↑ Ichii-Nakato N, Takata M, Takayanagi S, Takashima S, Lin J, Murata H, Fujimoto A, Hatta N, Saida T (September 2006). "High frequency of BRAFV600E mutation in acquired nevi and small congenital nevi, but low frequency of mutation in medium-sized congenital nevi". J. Invest. Dermatol. 126 (9): 2111–8. doi:10.1038/sj.jid.5700366. PMID 16691193.
- ↑ Wu J, Rosenbaum E, Begum S, Westra WH (December 2007). "Distribution of BRAF T1799A(V600E) mutations across various types of benign nevi: implications for melanocytic tumorigenesis". Am J Dermatopathol. 29 (6): 534–7. doi:10.1097/DAD.0b013e3181584950. PMID 18032947.
- ↑ Dessars B, De Raeve LE, Morandini R, Lefort A, El Housni H, Ghanem GE, Van den Eynde BJ, Ma W, Roseeuw D, Vassart G, Libert F, Heimann P (January 2009). "Genotypic and gene expression studies in congenital melanocytic nevi: insight into initial steps of melanotumorigenesis". J. Invest. Dermatol. 129 (1): 139–47. doi:10.1038/jid.2008.203. PMID 18633438.
- ↑ Charbel C, Fontaine RH, Malouf GG, Picard A, Kadlub N, El-Murr N, How-Kit A, Su X, Coulomb-L'Hermine A, Tost J, Mourah S, Aractingi S, Guégan S (April 2014). "NRAS mutation is the sole recurrent somatic mutation in large congenital melanocytic nevi". J. Invest. Dermatol. 134 (4): 1067–1074. doi:10.1038/jid.2013.429. PMID 24129063.
- ↑ Mark GJ, Mihm MC, Liteplo MG, Reed RJ, Clark WH (September 1973). "Congenital melanocytic nevi of the small and garment type. Clinical, histologic, and ultrastructural studies". Hum. Pathol. 4 (3): 395–418. PMID 4756859.
- ↑ "Precursors to malignant melanoma. National Institutes of Health Consensus Development Conference Statement, Oct. 24-26, 1983". J. Am. Acad. Dermatol. 10 (4): 683–8. April 1984. PMID 6715623.
- ↑ Kokta V, Hung T, Al Dhaybi R, Lugassy C, Barnhill RL (April 2013). "High prevalence of angiotropism in congenital melanocytic nevi: an analysis of 53 cases". Am J Dermatopathol. 35 (2): 180–3. doi:10.1097/DAD.0b013e318260908c. PMID 22771898.