Intravascular nevus cell protrusion and aggregates in otherwise common melanocytic nevi Georgiana-Irina Tudor 1 Oana Stefan 1 , Victor Nica 1 , Raluca Tanasa 1 , Virginia Chitu 1,2 , Constantin Caruntu 2 , Cristiana Popp 1 , Mirela Cioplea 1 and Sabina Zurac 1,2 1 Colentina University Hospital 2 “Carol Davila” University of Medicine and Pharmacy Bucharest, Romania
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Intravascular nevus cell protrusion
and aggregates in otherwise
common melanocytic nevi
Georgiana-Irina Tudor 1 Oana Stefan1, Victor Nica1, RalucaTanasa1, Virginia Chitu1,2, Constantin Caruntu2, Cristiana Popp1,
Mirela Cioplea1 and Sabina Zurac1,2
1 Colentina University Hospital 2 “Carol Davila” University of Medicine and Pharmacy
Bucharest, Romania
♀, 36 yrs
abdomen
Intradermal nevus H&E, 100x
Intravascular nevus cell protrusion (IVNcP)
H&E, 400x CD 34, 400x
Intravascular nevus cell protrusion (IVNcP)
D2-40, 100x D2-40, 400x
Intravascular nevus cell
aggregates (IVNcA)
H&E, 200x CD 34, 400x
Study methods
Cross-sectional study
1154 benign cutaneous compound and intradermal nevi
January 2017- December 2018
Colentina University Hospital, Pathology Department
Study methods
Inclusion criteria:
-presence of intravascular nevus cell protrusions & intravascular nevus
cell aggregates (H&E, 10x objective), confirmed with
immunohistochemical stainings with S100, CD34, D2-40
Exclusion criteria-presence of the pseudovascular spaces
Study methods
80 nevi with vascular affinity
Demographic data
Anatomical region
Diameter, maximum thickness, dermal level of vascular interest
Results
78; 97%
2; 3%
Intravascular nevus cell protrusion and aggregates distribution
IVNcP
IVNcA+IVNcP
100% with
intravascular
nevus cell
protrusion!
Results
23; 29%
57; 71%
Gender ratio
Male
Female
Female:Male=2.5:1
Results
0
5
10
15
20
25
30
≤20 21-30 31-40 41-50 51-60 61-70 71-80
8
2623
16
2 3 2
Age interval
Age distribution
Median age 32 yrs (95% CI 16-80)
Results
30%
10%
1%
59%
Anatomical location
head and neck
unknown
limbs
trunk
Median diameter 0.7 cm
(95% CI 0.2-2.3)
Median of maximum tumor
thickness 0.31 cm (95% CI
0.07-0.9)
Level of dermal nevus cell
protrusion and aggregates Results
Upper dermis
Central/later part of the nevi
Discussions
Intravascular nevus cell protrusion and aggregates: ◦ young female
◦ small, thin lesion
◦ trunk/head and neck region
Discussions
Neural crest migration and mechanical transport theories
IVNcA IVNcP
(HE) (IHC)
Nodal melanocytic nevi
IVNcA (H&E, 400x) IVNcP (S100/CD34, 200x)
Limitations Additional sections
Incomplete clinical data (congenital/acquired)
Mechanisms that explain nevus cell vascular affinity?
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Kim, Hyun-Soo, Sang Hwa Lee, Hyung-Sik Moon, and Youn Wha Kim. “IntradermalMelanocytic Nevus with Lymphatic Nevus Cell Embolus: A Case Report.” Oncology Letters 7, no. 2 (February 2014): 331–33. doi: 10.3892/ol.2013.1704.
Kormos, Bernadett, Nóra Belső, Attila Bebes, Gábor Szabad, Sarolta Bacsa, MártaSzéll, Lajos Kemény, and Zsuzsanna Bata-Csörgő. “In Vitro Dedifferentiation of Melanocytes from Adult Epidermis.” Edited by Maria Deli. PLoS ONE 6, no. 2 (February 23, 2011): e17197. doi:10.1371/journal.pone.0017197.
Krengel S, Scope A, Dusza SW, Vonthein R, Marghoob AA. New recommendations for the categorization of cutaneous features of congenital melanocytic nevi. J Am Acad Dermatol 2012; Epub.
Krengel, S., A. Hauschild, and T. Schafer. “Melanoma Risk in Congenital MelanocyticNaevi: A Systematic Review.” British Journal of Dermatology 155, no. 1 (July 2006): 1–8. doi:10.1111/j.1365-2133.2006.07218.x.