Malignant melanoma are MSA positive in most cases (60-90%). However, spindle cell and desmoplastic malignant melanoma are MSA negative or only focally positive.
MSA is found in varying proportions of benign melanocytic tumours like junction naevus and compound naevus. In these lesions, the epidermal part may be strongly stained while the dermal part is weakly staiend or unstained. Moreover MSA is detected in most caeses of blue naevus, cellular blue naevus, dysplastic naevus, Spitz naevus etc.
MSA is also demonstrated in other tumours of melanocytic origin or differentiation (i.e., melanosome producing), such as clear cell sarcoma, proximal type epitheloid sarcoma, pulmonary blastoma, hepatoblastoma, phaeochromocytoma, melanotic neurofibroma and schwannoma and other neural crest derived tumours, as well as in so-called PEComas (perivascular epitheloid cell) derived from modified smooth muscle cells in the so-called tuberous sclerosis complex: angiomyolipoma, lymphangioleiomyoma(-tosis), and pulmonary sugar tumour, and cardiac rhabdomyoma.
There are a few reports of aberrant MSA expression in adenocarcinoma. This is probably due to contamination of the antibody.
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