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Immunohistochemical distinction of epithelioid histiocytic proliferations from epithelioid melanocytic nevi.

Abstract
Histiocytic tumors can be confused with melanocytic nevi and malignant melanoma and vice versa. To explore the use of immunohistochemistry for this diagnostic problem, we examined the expression of S-100 protein, gp100 (the antigen recognized by HMB-45), tyrosinase (T311), Melan-A (A103), Factor XIIIa (FXIIIa), and CD68 in 10 juvenile xanthogranulomas (JXGs), five epithelioid histiocytomas (EHs), and 15 melanocytic nevi composed of large epithelioid cells. All epithelioid melanocytic nevi were immunoreactive for Melan-A, tyrosinase, and S-100 protein in most melanocytes. Four nevi were completely negative with HMB-45. Nine nevi had only a minor HMB-45-positive component in the superficial dermis. Two nevi were diffusely HMB-45-positive. Melanocytes in all nevi were completely negative for FXIIIa. Thirteen nevi were completely negative for CD68. Two nevi contained rare cells with weak staining for CD68. All 15 histiocytic proliferations were completely negative for Melan-A, tyrosinase, and gp100. They lacked expression of S-100 protein or had at most 10% immunopositive cells. In JXGs, most cells were strongly reactive for CD68, although only a few were positive for FXIIIa. In EHs, 40% to 60% of cells were immunoreactive for FXIIIa, and only 20% to 30% were positive for CD68. Our results demonstrate that Melan-A and tyrosinase are sensitive and specific markers to distinguish epithelioid melanocytic nevi from epithelioid histiocytic tumors.
AuthorsK J Busam, S R Granter, K Iversen, A A Jungbluth
JournalThe American Journal of dermatopathology (Am J Dermatopathol) Vol. 22 Issue 3 Pg. 237-41 (Jun 2000) ISSN: 0193-1091 [Print] United States
PMID10871066 (Publication Type: Journal Article)
Chemical References
  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • CD68 antigen, human
  • MART-1 Antigen
  • MLANA protein, human
  • Melanoma-Specific Antigens
  • Neoplasm Proteins
  • S100 Proteins
  • Monophenol Monooxygenase
Topics
  • Antigens, CD
  • Antigens, Differentiation, Myelomonocytic
  • Antigens, Neoplasm
  • Biomarkers, Tumor
  • Diagnosis, Differential
  • Histiocytoma, Benign Fibrous (diagnosis)
  • Humans
  • MART-1 Antigen
  • Melanoma-Specific Antigens
  • Monophenol Monooxygenase
  • Neoplasm Proteins
  • Nevus, Pigmented (diagnosis)
  • S100 Proteins
  • Skin Neoplasms (diagnosis)
  • Xanthogranuloma, Juvenile (diagnosis)

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