Document Detail

Low-risk and high-risk histologic features in conjunctival primary acquired melanosis with atypia: Clinicopathologic analysis of 29 cases.
MedLine Citation:
PMID:  17255762     Owner:  NLM     Status:  MEDLINE    
The current World Health Organization classification of conjunctival melanocytic proliferations divides them into conjunctival nevi and invasive melanoma but, in contrast to other anatomic sites, does not recognize melanoma in situ. All atypical intraepithelial conjunctival proliferations are included in a heterogeneous category designated as primary acquired melanosis (PAM) with atypia. We performed clinicopathologic analysis of 29 cases of PAM with atypia. On the basis of histologic features and frequency of association with invasive melanoma and metastases, we were able to divide our cases into 2 histologic groups. The low-risk group (13 cases) included lesions composed of small to medium size melanocytes with high nuclear to cytoplasmic ratio and small to medium size hyperchromatic nuclei devoid of nucleoli showing predominantly single cell lentiginous growth pattern. Invasive melanoma occurred in only 2 cases from this group. None of these lesions metastasized. The second, high-risk group (16 cases), showed increased frequency of association with invasive melanoma (15/16 cases, 94%) and metastases (4/16 cases, 25%). These lesions were more heterogeneous architecturally but were all composed of melanocytes showing various degrees of epithelioid features such as abundant cytoplasm, vesicular nuclei, or prominent nucleoli. In 4 cases discrete areas showing high-risk and low-risk features were identified. All 4 lesions were associated with invasion. Our findings offer a practical approach for prognostically useful subclassification of PAM with atypia, which emphasizes cytologic features of intraepithelial conjunctival melanocytic proliferation.
Mitsuhiro Sugiura; Kathryn A Colby; Martin C Mihm; Artur Zembowicz
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The American journal of surgical pathology     Volume:  31     ISSN:  0147-5185     ISO Abbreviation:  Am. J. Surg. Pathol.     Publication Date:  2007 Feb 
Date Detail:
Created Date:  2007-01-26     Completed Date:  2007-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7707904     Medline TA:  Am J Surg Pathol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  185-92     Citation Subset:  IM    
Department of Pathology, Massachusetts General Hospital Harvard Medical School, Boston, MA, USA.
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MeSH Terms
Aged, 80 and over
Antibiotics, Antineoplastic / therapeutic use
Cell Nucleolus / pathology
Cell Nucleus / pathology
Chemotherapy, Adjuvant
Conjunctival Neoplasms / complications,  pathology*,  therapy
Cytoplasm / pathology
Diagnosis, Differential
Disease Progression
Melanocytes / pathology
Melanoma / complications,  pathology*,  therapy
Melanosis / complications,  pathology*,  therapy
Middle Aged
Mitomycin / therapeutic use
Neoplasm Recurrence, Local
Reg. No./Substance:
0/Antibiotics, Antineoplastic; 50-07-7/Mitomycin

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