Deep penetrating nevus: a case report and brief literature review

BACKGROUND -: Deep penetrating nevus (DPN) is a distinct variant of melanocytic nevus and remains a histopathologic challenge to pathologists because of its resemblance to blue nevus, malignant melanoma, pigmented Spitz nevus, and congenital melanocytic nevus. It often goes unrecognized due to its relative rarity. CASE PRESENTATION -: Here we report a case of DPN of the left anterior leg in a 51-year old female. A brief review of the literature shows that these lesions have a distinct growth pattern and cellular morphology that can differentiate these lesions from other entities including malignant melanoma. CONCLUSION -: It is important to recognize these features because DPN carries a better prognosis than malignant melanoma

3q26 amplification is an effective negative triage test for LSIL: a historical prospective study.

BACKGROUND: Women with low grade squamous intraepithelial lesions (LSIL) at cervical cancer screening are currently referred for further diagnostic work up despite 80% having no precancerous lesion. The primary purpose of this study is to measure the test characteristics of 3q26 chromosome gain (3q26 gain) as a host marker of carcinogenesis in women with LSIL. A negative triage test may allow these women to be followed by cytology alone without immediate referral to colposcopy. METHODS AND FINDINGS: A historical prospective study was designed to measure 3q26 gain from the archived liquid cytology specimens diagnosed as LSIL among women attending colposcopy between 2007 and 2009. 3q26 gain was assessed on the index liquid sample; and sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were measured at immediate triage and at 6-16 months after colposcopic biopsy. The sensitivity of 3q26 gain measured at immediate triage from automated and manually reviewed tests in 65 non-pregnant unique women was 70% (95% CI: 35, 93) with a NPV of 89% (95% CI: 78, 96). The sensitivity and NPV increased to 80% (95% CI: 28, 99) and 98% (95% CI: 87, 100), respectively, when only the automated method of detecting 3q26 gain was used. CONCLUSIONS: 3q26 gain demonstrates high sensitivity and NPV as a negative triage test for women with LSIL, allowing possible guideline changes to routine surveillance instead of immediate colposcopy. Prospective studies are ongoing to establish the sensitivity, specificity, PPV and NPV of 3q26 gain for LSIL over time

Trial profile.

<p>Trial profile.</p

Test characteristics of 3q26 gain for women with LSIL cytology for detecting CIN 2/3 using automated 3q26 gain analysis alone.

<p>Sensitivity = 80% (95% CI: 28, 99).</p><p>Specificity = 89% (95% CI: 76, 96).</p><p>PPV = 44% (95% CI: 14, 79).</p><p>NPV = 98% (95% CI: 87, 100).</p><p>PPV means positive predictive value.</p><p>NPV means negative predictive value.</p><p>CIN 2/3 means cervical intraepithelial neoplasia grade 2 or 3.</p><p></p

Descriptors of LSIL^* Subjects.

*<p>LSIL means low grade squamous intraepithelial lesion.</p>†<p>CIN means cervical intraepithelial neoplasia grade 1, 2 or 3.</p

Cells positive and negative for 3q26 gain.

<p>Cells positive (Panel A) or negative (Panel B) for 3q26 gain detected in subjects with LSIL cytology. 3q26 fluorescnce in situ hybridization (FISH) signals are colored gold and control centromeric 7 FISH signals are colored aqua. A positive test contains two or more cells exhibiting more than four 3q26 (gold) FISH signals.</p

Test characteristics of 3q26 gain for women with LSIL cytology for detecting CIN 2/3 using automated and manual review of 3q26 gain analysis.

<p>PPV means positive predictive value.</p><p>NPV means negative predictive value.</p><p>CIN 2/3 means cervical intraepithelial neoplasia grade 2 or 3.</p><p></p