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Mitosen bei frühinvasiven malignen Melanomen

Wie sicher ist die histogenetische Zuordnung im Stadium pT1?

Mitosis in early invasive malignant melanoma

How reliable is histogenetic classification at stage pT1?

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Zusammenfassung

Seit Anfang Februar 2010 wurde am Institut für Pathologie des Krankenhauses der Barmherzigen Schwestern die neue Stadieneinteilung bzw. Klassifikation des American Joint Committee on Cancer (AJCC) von 2009 in den diagnostischen Alltag übernommen. Da der Anzahl der Mitosen/mm2 nach diesen Richtlinien eine zentrale Bedeutung zufällt, konnten wir gemäß dieser Empfehlungen für Melanome im Stadium pT1 eine deutliche Verschiebung vom Stadium pT1a in das Stadium pT1b beobachten. Dies betraf verstärkt jene Tumoren, die sich in der Kategorie pT1a nach der Union-for-International-Cancer-Control(UICC)-Klassifikation (7. Aufl.) minimal-invasiv verhielten. Eine Zuordnung von Mitosen bei frühinvasiven Melanomen in Bezug auf einen möglichen epithelialen oder melanozytären Ursprung ist nicht immer eindeutig. Somit ist nicht auszuschließen, dass Melanome aus dem Stadium pT1a nach UICC aufgrund diagnostischer Unsicherheiten fälschlicherweise ins Stadium pT1b (AJCC) verschoben werden.

Abstract

Since early February 2010 we have been implementing the latest version of the 2009 AJCC Melanoma Staging and Classification in our institution. Since, according to the guidelines for stage pT1 melanomas, the number of mitoses/mm2 is of particular significance, we have been able to observe a notable shift from pT1a to pT1b. Highlighting the mitotic count as one of the key features of the diagnosis of malignant melanoma, we observed that the major part of stage-switched melanomas belonged to a minimally invasive subset of melanomas previously categorized as pT1a UICC (7th edition). A level of reasonable doubt remains regarding the distinct histogenetic classification of mitosis as early stage melanoma with regard to their epithelial or melanocytic origin.

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Authors and Affiliations

  1. Institut für Pathologie, Krankenhaus der Barmherzigen Schwestern Linz, Seilerstätte 4, 4020, Linz, Österreich

    H. Bösmüller & S. Haitchi-Petnehazy

  2. Abteilung für Plastische Chirurgie, Krankenhaus der Barmherzigen Schwestern Linz, Linz, Österreich

    T. Hintringer

  3. Institut für Dermatopathologie Friedrichshafen, Friedrichshafen, Deutschland

    T. Mentzel

Authors
  1. H. Bösmüller
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  2. S. Haitchi-Petnehazy
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  3. T. Hintringer
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  4. T. Mentzel
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Correspondence to H. Bösmüller.

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Bösmüller, H., Haitchi-Petnehazy, S., Hintringer, T. et al. Mitosen bei frühinvasiven malignen Melanomen. Pathologe 33, 113–117 (2012). https://doi.org/10.1007/s00292-011-1465-8

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