Melanocytes and melanosis of the oesophagus in Japanese subjects: analysis of factors effecting their increase. Virchows Arch [A]

2nd Department of Pathology, Faculty of Medicine, Tokyo Medical and Dental University, Japan.
Virchows Archiv. A, Pathological anatomy and histopathology 02/1990; 417(2):137-43.
Source: PubMed


Normal oesophagus specimens taken from 65 autopsy cases and surgical specimens from 127 oesophageal carcinoma cases were examined histopathologically to determine melanocyte incidence and distribution. Melanocytes were found in the epithelio-stromal junction in 7.7% of normal oesophagus specimens examined at autopsy, and in 29.9% of surgical cases with oesophageal carcinoma. Positive specimens in the latter groups, especially from pre-operatively irradiated individuals, showed a more remarkable increase of melanocytes than was evident in any of the normal oesophageal samples. There were no significant differences in incidence between males and females, or between age groups. In cases where the cancer invaded into deeper stroma, the melanocytes were mainly observed in the normal epithelium around the carcinomas. Epithelial and stromal elements of the melanotic mucosa commonly showed hyperplastic changes such as acanthosis or basal cell hyperplasia, and chronic oesophagitis. Melanocytes were observed most commonly in the lower part of the oesophagus, the site where malignant melanoma of the oesophagus, most often originates. These results strongly suggest that the melanocyte increase observed in areas of hyperplastic epithelium and chronic oesophagitis may play an important role as a precursor lesion for malignant melanoma in the oesophagus.

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    • "Presence of melanocytes in esophageal mucosa was first demonstrated by De La Pava in 1963 [4]. Ohashi et al. [68] have found melanocytes in 7.7% of normal esophagus specimens in Japanese, and in 29.9% of cases with esophageal carcinoma. They found that melanocytes are mostly located in the lower part of esophagus , and that their number is increased in areas of hyperplastic epithelium and chronic esophagitis . "
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    ABSTRACT: Primary mucosal melanomas arise from melanocytes located in mucosal membranes lining respiratory, gastrointestinal and urogenital tract. Although a majority of mucosal melanomas originate from the mucosa of the nasal cavity and accessory sinuses, oral cavity, anorectum, vulva and vagina, they can arise in almost any part of mucosal membranes. Most of mucosal melanomas occur in occult sites, which together with the lack of early and specific signs contribute to late diagnosis, and poor prognosis. Because of their rareness the knowledge about their pathogenesis and risk factors is insufficient, and also there are not well established protocols for staging and treatment of mucosal melanomas. Surgery is the mainstay of treatment, with trends toward more conservative treatment since radical surgery did not show an advantage for survival. Radiotherapy can provide better local control in some locations, but did not show improvement in survival. There is no effective systemic therapy for these aggressive tumors. Compared with cutaneous and ocular melanoma, mucosal melanomas have lowest percent of five-year survival. Recently revealed molecular changes underlying mucosal melanomas offer new hope for development of more effective systemic therapy for mucosal melanomas. Herein we presented a comprehensive review of various locations of primary melanoma along mucosal membranes, their epidemiological and clinical features, and treatment options. We also gave a short comparison of some characteristics of cutaneous and mucosal melanomas.
    International journal of clinical and experimental pathology 10/2012; 5(8):739-53. · 1.89 Impact Factor
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    • "It is extremely rare in western countries and only six cases have been described thus far [2]. Melanocytosis seems to be more frequent in Eastern countries, especially India and Japan [3]. It appears to be linked to chronic irritation like reflux or alcohol and to be premalignant because melanocytosis has been found in association with esophageal melanoma [4] [5]. "
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    ABSTRACT: A heavy drinker and smoker had a normal UGI-endoscopy in 1996. In 1999, a repeat examination disclosed distal esophageal benign melanocytosis, typical, macro- and microscopically. Endoscopic and microscopic features were stable in 2002 and 2004. In 2007, dysphagia prompted an endoscopy, which disclosed a poorly differentiated epidermoid carcinoma at 19cm and black nodules of the cardia with a microscopy typical of malignant melanoma, uT3N1 at EUS. Radiochemotherapy led to an 8-month improvement, which did not prevent death one year after diagnosis.
    Gastroentérologie Clinique et Biologique 09/2012; 37(2). DOI:10.1016/j.clinre.2012.08.003 · 1.64 Impact Factor
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    ABSTRACT: Primary melanoma of the esophagus is a very rare and aggressive neoplasm; only a small number of patients survive more than 1 year after initial diagnosis. We describe a case of primary melanoma of the esophagus in a woman with a history of invasive breast cancer. The patient suffered from dysphagic and dyspeptic disorders. The abdomen ultrasonography and the esophagogastroscopy showed a lesion located at the esophago-gastric junction extending to the gastric fundus. Histological and immunohistochemical studies revealed a primary esophageal infiltrating melanoma. A total gastrectomy and regional lymphadenectomy with a partial resection of the distal esophagus was performed. During laparotomic exploration, numerous dark lymp hnodes were found. On frozen sections, surprisingly neither malignant cells nor melanin were detected in the lymph nodes. Resection margins were not involved with the tumor. Patient is still alive with no evidence of recurrence at 24 months after surgical treatment, alone.
    Anticancer research 07/2007; 27(4C):2849-53. · 1.83 Impact Factor
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