Desmoplastic (Sclerotic) Nevus
- 1 July 1999
- journal article
- research article
- Published by Ovid Technologies (Wolters Kluwer Health) in The American Journal of Surgical Pathology
- Vol. 23 (7), 786-94
- https://doi.org/10.1097/00000478-199907000-00006
Abstract
Desmoplastic (sclerotic) nevus, a benign melanocytic neoplasm characterized by predominantly spindle-shaped nevus cells within a fibrotic stroma, can be confused with fibrous lesions and other melanocytic proliferations, including desmoplastic melanoma. We compared the histologic and immunohistochemical features of 16 desmoplastic nevi, nine desmoplastic melanomas, four hypopigmented blue nevi, and six dermatofibromas. The similarities between desmoplastic nevi and dermatofibromas included epidermal hyperplasia (12 of 16), presence of keloidal collagen (15 of 16), hypercellularity (16 of 16), and increased numbers of factor XIIIa-positive dendritic cells (12 of 12). The absence of adnexal induction (0 of 16), the rarity of lesions with multinucleated cells (3 of 16) or epidermal hyperpigmentation (2 of 16), and the presence of S-100 immunoreactivity (16 of 16) and melanocytic proliferation (9 of 16) helped differentiate desmoplastic nevi from dermatofibromas. The similarities between desmoplastic nevi and desmoplastic melanomas included the presence of atypical cells (16 of 16) and HMB-45 expression in the superficial portion of the lesions (11 of 16). The infrequent location on the head or neck (1 of 16), the absence of mitotic figures (0 of 16), a significantly lower number of Ki-67-reactive cells, and a decrease in HMB-45 expression in the deep area of the lesions (8 of 11) helped distinguish desmoplastic nevi from desmoplastic melanoma. Desmoplastic nevi had overlapping features with hypopigmented blue nevi, but features tending to favor the latter included a predominance of ovoid nuclei, higher numbers of atypical cells, and homogeneous staining with HMB-45. We conclude that a combination of histologic and immunohistochemical criteria facilitates the reliable diagnosis of desmoplastic nevus from its simulators.Keywords
This publication has 27 references indexed in Scilit:
- Nevoid malignant melanoma: morphologic patterns and immunohistochemical reactivityJournal of Cutaneous Pathology, 1995
- Utility of a proliferation marker in distinguishing between benign naevocellular naevi and naevocellular naevus-like lesions with malignant propertiesMelanoma Research, 1995
- Who needs zebras?: Comments on desmoplastic melanomaJournal of the American Academy of Dermatology, 1995
- Desmoplastic malignant melanomaJournal of the American Academy of Dermatology, 1995
- Desmoplastic Malignant MelanomaPlastic and Reconstructive Surgery, 1995
- Pathology and prognostic factorsCurrent Opinion in Oncology, 1993
- The desmoplastic melanocytic naevus: a distinct histological entityHistopathology, 1992
- Factor XIIIa in nodular malignant melanoma and Spitz naeviBritish Journal of Dermatology, 1990
- Proliferative Activity of Cutaneous Melanocytic Tumors Defined by Ki-67 Monoclonal AntibodyThe American Journal of Dermatopathology, 1989
- Age-related changes in melanocytic naeviClinical and Experimental Dermatology, 1979