Desmoplastic melanoma

Desmoplastic melanomas pose particular diagnostic difficulties, since they commonly lack immunoreactivity for the markers used to identify non-desmoplastic melanomas. Apart from S-100, MAGE-1 may be the only marker useful in desmoplastic melanoma4. Desmoplastic melanoma appears to be close in immunophenotype to peripheral nerve sheath tumours and they share mutations of the NF1 gene.

Immunohistochemistry

 

S-100

Tyrosinase

Mitf

Melan-A

MAGE-1

PNL2

HMB-45

negative

0/201, 0/84, 1/215

 

9/201, 30/302, 0/23, 8/84

13/201, 30/302, 8/84, 15/215

30/302, 8/84, 11/135

5/84

12/136

14/201, 30/302, 8/84, 17/215

 

 

p
o
s
i
t
i
v
e

<5% of cells

0/201

5/201

4/201

 

 

 

5/201

5-25% of cells

1/201

3/201

2/201

 

 

 

1/201

25-50% of cells

2/201

2/201

1/201

 

 

1/136

0/201

50-75% of cells

5/201

1/201

0/201

 

 

 

0/201

>75% of cells

12/201

0/201

0/201

 

 

 

0/201

any degree of positivity

 

20/201, 30/302, 8/84, 20/215, 26/267, 172/1787a

11/201

7/201, 6/215

2/135

3/84

1/136 

6/201, 4/215, 5/247, 6/937a

 
 

vimentin

25/257, 23/247a

  

NSE

10/247, 15/237a

FXIIIa

7/237, 15/157a

EMA

10/237, 0/17a

cytokeratins

0/257, 1/177a

NKIC3

9/197a

Desmin

7/277a

A1AT

0/127a

FVIII

0/17a
   

 

References

1KJ Busam et al. Analysis of microphthalmia transcription factor expression in normal tissues and tumors, and comparison of its expression with S-100 protein, gp100 and tyrosinase in desmoplastic malignant melanoma. Am J Surg Pathol 2001;25:197-204.

2Miettinen M et al. Microphthalmia transcription factor in the immunohistochemical diagnosis of metastatic melanoma: comparison with four other melanoma markers. Am J Surg Pathol 2001;25:205-211.

3Clarkson KS et al. The usefulness of tyrosinase in the immunohistochemical assessment of melanocytic lesions: a comparison of the novel T311 antibody (anti-tyrosinase) with S-100, HMB-45 and A103 (anti-melan-A). J Clin Pathol 2001;54:196-200.

4Xu, X., Chu, A. Y., Pasha, T. L., Elder, D. E., Zhang, P. J. Immunoprofile of MITF, tyrosinase, melan-A, and MAGE-1 in HMB45- negative melanomas. Am J Surg Pathol 2002;26:82-87.

5Granter, S.R., Weilbaecher, K.N., Quigley, C., Fletcher, C.D. and Fisher, D.E. Microphthalmia transcription factor: not a sensitive or specific marker for the diagnosis of desmoplastic melanoma and spindle cell (non- desmoplastic) melanoma. Am J Dermatopathol 2001;23:185-9.

6Busam KJ, Kucukgol D, Sato E, Frosina D, Teruya-Feldstein J,Jungbluth AA Immunohistochemical Analysis of Novel Monoclonal Antibody PNL2 and Comparison With Other Melanocyte Differentiation Markers. Am J Surg Pathol 2005; 29:400-406

7 Carlson JA, Dickersin GR, Sober AJ, et al. Desmoplastic neurotropic melanoma. A clinicopathologic analysis of 28 cases. Cancer 1995; 75:478-94 Reference 7a is a compilation of published literature summarised in reference 7

 

This page last revised 30.10.2008.