Reflected light microscopy, melanophagus-fringed regression zones

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Regression zones with marginal melanophages; regressive remodelling with marginal melanophages; unstructured areas with peripheral grey-blue/purple collections of melanophages

Definition
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Reflected light microscopic phenomenon in which brightened, structureless and low-pigment areas (regression zones) are surrounded by melanophagus agglomerates.

General information
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Reflected light microscopy: Within the lesion, nearly depigmented areas are surrounded by loosely aggregated, slate-grey or bluish-violet, pepper-like ("peppering") granulated melanophagus clusters.

Occurrence
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In the group of benign and malignant pigment cell tumors, the specificity of the melanophagus-fringed zones for malignant melanomas is over 90% (sensitivity 41%). This phenomenon is less frequently observed in so-called dysplastic or regressive melanocytic nevi.

Histology
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The bright areas correspond to connective tissue regression zones within the papillary and reticular stratum. Tumour replacement tissue appears whitish opaque, pink (shimmering vessels) or bluish grey (shimmering melanophages). The reticules are largely destroyed. Melanin-enriched melanophages, which do not secrete melanin pigment, are typically located at the edges of the regression zones.

Literature
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  1. Fritsch P, Pechlaner R (1981) Differentiation of benign from malignant melanocytic lesions using incident light microscopy. In: Ackerman AB (ed) Pathology of malignant melanoma. Masson, New York
  2. Kreusch J, Rassner G (1990) Structural analysis of melanocytic pigment moles by reflected light microscopy. dermatologist 41: 27-33
  3. Leiter U et al (2004) Prognostic factors of thin cutaneous melanoma: an analysis of the central malignant melanoma registry of the german dermatological society. J Clin Oncol 22: 3660-3667
  4. Schulz H (1992) Reflected light microscopic score for the differential diagnosis of dysplastic nevi. dermatologist 43: 487-490

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Last updated on: 29.10.2020