5-Hydroxymethylcytosine expression in metastatic melanoma versus nodal nevus in sentinel lymph node biopsies

Sentinel lymph node biopsies are conducted to stage patients with newly diagnosed melanomas that have histopathological attributes conferring defined levels of metastatic potential. Because benign nevic cells may also form ‘deposits' in lymph nodes (nodal nevus), the pathological evaluation for...

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Bibliographic Details
Published in:Modern pathology 2015-02, Vol.28 (2), p.218-229
Main Authors: Lee, Jonathan J, Granter, Scott R, Laga, Alvaro C, Saavedra, Arturo P, Zhan, Qian, Guo, Weimin, Xu, Shuyun, Murphy, George F, Lian, Christine G
Format: Article
Language:English
Subjects:
5-Methylcytosine - analogs & derivatives
Adult
Aged
Aged, 80 and over
Biomarkers, Tumor - analysis
Cytosine - analogs & derivatives
Cytosine - analysis
Cytosine - biosynthesis
Female
Fluorescent Antibody Technique
Humans
Immunohistochemistry
Lymph Nodes - pathology
Lymphatic Metastasis - diagnosis
Male
Melanoma - diagnosis
Middle Aged
Nevus - diagnosis
Sentinel Lymph Node Biopsy
Skin Neoplasms - diagnosis
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Summary:Sentinel lymph node biopsies are conducted to stage patients with newly diagnosed melanomas that have histopathological attributes conferring defined levels of metastatic potential. Because benign nevic cells may also form ‘deposits' in lymph nodes (nodal nevus), the pathological evaluation for metastatic melanoma within sentinel lymph nodes can be challenging. Twenty-eight sentinel lymph node biopsy cases containing either metastatic melanoma (N=18) or nodal nevi (N=10) were retrieved from the archives of the Brigham and Women's Hospital, Department of Pathology (2011–2014). In addition, two sentinel lymph node cases that were favored to represent metastatic disease but whose histopathological features were viewed as equivocal, with melanoma favored, were also included. Dual labeling for the melanocyte lineage marker, MART-1, and the epigenetic marker, 5-hydroxymethylcytosine, a functionally significant indicator that has been shown to distinguish benign nevi from melanoma, was performed on all cases using immunohistochemistry and/or direct immunofluorescence. All (18 of 18) metastatic melanoma cases showed complete loss of 5-hydroxymethylcytosine nuclear staining in MART-1-positive cells, and all (10 of 10) nodal nevus cases demonstrated 5-hydroxymethylcytosine nuclear staining in MART-1-positive cells. In addition, 5-hydroxymethylcytosine staining confirmed the favored diagnoses of metastatic melanoma in the two ‘equivocal' cases. Thus, 5-hydroxymethylcytosine may be a useful adjunctive marker to distinguish between benign nodal nevi and metastatic melanoma during the evaluation of sentinel lymph node biopsies for metastatic melanoma.
ISSN:0893-3952
1530-0285
DOI:10.1038/modpathol.2014.99