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Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-12
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... in association with any given nevus is extremely low. CLINICAL FEATURES Parameters for the clinical diagnosis of SSM are referred to as ABCD criteria ( Table 12-1 ): asymmetry, an irregular border, multiple colors, and a diameter greater than 6 mm are the clinical features that suggest melanoma, especially...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-15
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... of melanin pigment. They tend to grow faster and are thicker at the time of diagnosis. Furthermore, they can be more easily confused with metastatic melanoma. CLINICAL FEATURES Clinically, nodular melanoma presents as a papule, nodule, or plaque ( fig. 15-1 ). If there is an associated nevus precursor...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-19
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... with focal necrosis (see fig. 19-3 ). Spitzoid melanomas may have a deep bulbous growth and tongue-like extensions ( fig. 19-6 ), but these findings are neither necessary nor sufficient for a diagnosis of malignancy. SPITZOID MELANOMA (OF CHILDHOOD) Figure 19-6 SPITZOID MELANOMA (OF CHILDHOOD...
Images
EPIDERMOTROPIC METASTATIC MELANOMA  A: Metastatic melanoma is present in th...
Published: 01 February 2024
EPIDERMOTROPIC METASTATIC MELANOMA Figure 22-7 EPIDERMOTROPIC METASTATIC MELANOMA A: Metastatic melanoma is present in the epidermis and dermis. This metastasis simulates the appearance of a primary melanoma. The intraepidermal melanoma extends peripheral to the dermal tumor cells. Clinicopatholo... More about this image found in EPIDERMOTROPIC METASTATIC MELANOMA A: Metastatic melanoma is present in th...
Images
UNDIFFERENTIATED MELANOMA  An amelanotic undifferentiated malignant spindle...
Published: 01 February 2024
UNDIFFERENTIATED MELANOMA Figure 21-8 UNDIFFERENTIATED MELANOMA An amelanotic undifferentiated malignant spindle cell neoplasm is seen. It was initially interpreted as sarcoma by a soft tissue pathologist, but the diagnosis was revised to metastatic melanoma after sequence analysis revealed UV signatures and an NRAS Q61R mutation identical to the mutation in the patient’s prior primary melanoma located draining to the site of the undifferentiated tumor. More about this image found in UNDIFFERENTIATED MELANOMA An amelanotic undifferentiated malignant spindle...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-17
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
...Nevoid melanoma is a melanoma that closely resembles a melanocytic nevus microscopically. It is not a distinct clinical, microscopic, or molecular entity. The term nevoid melanoma refers to a diagnostic pitfall: “a diagnosis of a nevus that you later regret” ( 1 ). Most often the term...
Images
DYSPLASTIC NEVUS  A: Multiple red and brown lesions are present on the uppe...
Published: 01 February 2024
DYSPLASTIC NEVUS Figure 4-1 DYSPLASTIC NEVUS A: Multiple red and brown lesions are present on the upper back shoulder. The arrow points to a lesion, which was excised, and the diagnosis histopathologically confirmed as dysplastic nevus. B: The lesion has a diameter of more than 4 mm and displays... More about this image found in DYSPLASTIC NEVUS A: Multiple red and brown lesions are present on the uppe...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-13
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... have a long latent period, sometimes lasting decades, before invasive melanoma develops. When the histopathologic findings are subtle or relevant clinical information is not available, pathologists may hesitate to render a precise diagnosis. A descriptor, such as “atypical intraepidermal melanocytic...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-21
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... the diagnosis of melanoma even when presented with unusual features. BALLOON CELL/CLEAR CELL MELANOMA Balloon cell/clear cell melanoma is characterized by the presence of tumor cells with distinct cytoplasmic features ( 1 ). On hematoxylin and eosin (H&E)-stained sections, the tumor cells usually...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-22
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... METASTATIC MELANOMA A: Metastatic melanoma is present in the epidermis and dermis. This metastasis simulates the appearance of a primary melanoma. The intraepidermal melanoma extends peripheral to the dermal tumor cells. Clinicopathologic correlation is essential to establish the correct diagnosis. B...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-04
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... on the upper back shoulder. The arrow points to a lesion, which was excised, and the diagnosis histopathologically confirmed as dysplastic nevus. B: The lesion has a diameter of more than 4 mm and displays slightly irregular borders and some variation in pigmentation. (Courtesy of Dr. M. Marchetti, New York...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-18
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... measure more than 1 cm in diameter at the time of diagnosis and display a bluish-gray or brown color. MICROSCOPIC FINDINGS Melanoma Associated with a Common Blue Nevus. In one series of 23 blue nevus-associated melanomas, six blue nevi were of the common type ( 6 ). In this scenario, the melanoma...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-14
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... ( Table 14-1 ). The mean age at diagnosis is between 60 and 70 years ( 1 , 8 – 12 ). Most tumors (approximately 80 percent) develop on the foot, most often on the heel ( fig. 14-1 ). Subungual melanomas account for 20 to 40 percent of acral melanomas. They preferentially affect the great toes...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-05
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... OF A TEENAGER A: The silhouette of the lesion shows a mixed lentiginous junctional and nested growth pattern of melanocytes. B: In the center of the lesion are several melanocytes in the spinous and granular cell layer. Differential Diagnosis. The difficulty of distinguishing atypical acral nevi from...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-08
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... common  Periadnexal aggregation of dendritic cells often  Infiltration of smooth muscle, nerves Differential Diagnosis  Dermal melanocytoses  Pigmented neurofibroma  Melanosis, postinflammatory hyperpigmentation  Melanoma, especially BN-like metastatic melanoma Microscopic Findings...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-23
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
...PROGNOSTIC FACTORS Once a diagnosis of melanoma has been established, it is important for the pathologist to provide prognostic information for patients and their clinical care team. At the time of diagnosis approximately 90 percent of individuals with primary cutaneous melanoma have no evidence...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-07
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... are solitary, but on occasion, multiple lesions are present at the same time, agminated (grouped) or diffusely and randomly distributed (disseminated). Multiple Spitz nevi also occur in a background of a congenital nevus. Dermoscopy can aide in the clinical diagnosis of Spitz nevi. Pigmented Spitz nevi...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-01
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
...  Basal layer hyperpigmentation  Normal density of melanocytes or solar melanocyte hyperplasia  No cytologic atypia  May be inflamed  May be associated with melanophages Differential Diagnosis  Pigmented actinic keratosis  Macular pigmented seborrheic keratosis  Lichenoid...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-16
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
..., especially if there was a prior diagnosis of lentigo maligna. The clinical recognition of DM without pigment background is very challenging. Dermoscopic features are of limited value ( 12 ). Amelanotic DM may be confused with a scar, fibroma, cyst, or keratinocyte (basal cell or squamous cell) carcinoma...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-06
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... cell layer. Differential Diagnosis Persistent or traumatized nevi may be confused with in situ or invasive melanoma. Features useful in distinguishing the two entities are summarized in Table 6-1 . A clinical history and review of the original lesion are important for rendering the correct diagnosis...