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Immunohistochemical analysis of KBA.62 in 18 neurothekeomas: a potential marker for differentiating neurothekeoma, but a marker that may lead to confusion with melanocytic tumors

Authors

  • Andrea Suarez,

    1. Department of Dermatology, New York Presbyterian Hospital/Weil Cornell Medical Center, New York, NY, USA
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  • Whitney A. High

    Corresponding author
    1. Departments of Dermatology and Pathology, University of Colorado, Aurora, CO, USA
    • Dr Whitney A. High

      Departments of Dermatology and Pathology, University of Colorado, 1999 North Fitzsimons Parkway, Bioscience East, Suite 120, Aurora, CO 80045, USA

      Tel: +1 303 344 1290

      Fax: +1 303 577 2302

      e-mail: Whitney.High@ucdenver.edu

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Abstract

Background

Neurothekeoma represents a neoplasm of uncertain histogenesis that often occurs on the head and neck of younger individuals. Distinguishing neurothekeoma from other tumors, particularly malignancies such as melanoma, can be difficult given the variable presence of nuclear atypia, mitoses and extension into fat or skeletal muscle. KBA.62 represents an anti-melanoma monoclonal antibody that marks approximately 93% of melanomas. This study sought to evaluate KBA.62 expression in neurothekeomas, both as means of affirming the diagnosis and as a potential confounding factor in excluding a melanocytic process.

Methods

Eighteen neurothekeomas from 17 patients were analyzed by light microscopy and immunohistochemistry. Immunohistochemistry was performed with KBA.62, S100 and CD10 antibodies. The diagnosis of neurothekeoma was confirmed by at least two dermatopathologists.

Results

All cases showed similar light microscopic and immunohistochemical features. With the exception of two cases, cells expressed CD10 and exhibited morphologic features consistent with neurothekeoma. All 18 cases were S100 immunonegative. The epithelioid cells of all neurothekeomas were KBA.62 immunopositive, including both of two neurothekeomas occurring in the same patient.

Conclusions

In this study 100% of neurothekeomas tested were KBA.62 positive, admittedly to varying degrees, suggesting the utility of this reagent as being supportive of the diagnosis of neurothekeoma.

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