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Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-21
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... in the potential for diagnostic confusion with skin adnexal (sebaceous or sweat gland) neoplasms, metastatic renal cell carcinoma, or xanthomatous histiocytic proliferations. DEEP PENETRATING NEVUS-LIKE (PLEXIFORM) MELANOMA Some melanomas may be confused with, or arise in association with, a deep penetrating...
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
...The term spitzoid melanoma is used for a melanoma bearing some resemblance to a Spitz nevus ( 1 ). It is a diagnostic pitfall ( 2 ): a melanocytic neoplasm may at first glance look like an atypical Spitz nevus or Spitz tumor, but is eventually diagnosed as melanoma based on clinical follow...
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...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-20
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... are typical for melanomas that develop in large (20 to 40 cm projected adulthood diameter) or giant (over 40 cm projected adulthood diameter) congenital melanocytic nevi. MICROSCOPIC FINDINGS Conventional Adult-Type Melanomas. The spectrum of microscopic features and related diagnostic criteria are similar...
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
... sections, but cytogenetic tests can provide useful diagnostic information for microscopically ambiguous or diagnostically controversial tumors, especially if there is a potentially invasive melanoma with risk for metastasis. Fluorescence in situ hybridization (FISH) is the preferred method for small...
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
.... B: The melanocytes are arranged in nests and solitary units. They display evidence of maturation and bland nuclear features. Several multinucleated melanocytes are present. Ear Nevi. Nevi from the ear are diagnostically challenging because of the partial and superficial nature of many...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-09
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
.... Blue nevi harbor GNAQ, GNA11, CYSLTR2, or PLCB4 mutations where as DPN have beta-catenin or APC mutations in combination with BRAF, MEK, or HRAS mutations. The clinically most important diagnostic challenge is between a DPN with atypical features...
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
... with a higher degree of nuclear atypia than the associated residual nevus, is diagnostically helpful. Table 18-1 FEATURES OF BLUE NEVUS-RELATED MELANOMA Clinical Features  Most often located on the scalp, but may occur anywhere  There may be a history of a blue nevus that has changed...
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
... is difficult, instead of opting for a high-grade annotation, one may simply acknowledge the presence of diagnostic uncertainty and express worries about a possible melanoma in a comment. Since dysplastic nevi are uncommon on the face other than around the upper forehead and temples, one should hesitate...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-11
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... chromatin and prominent nucleoli. The melanocytes of a deep penetrating nevus commonly display plexiform growth, following neurovascular structures into the deep dermis or subcutis. In diagnostically challenging cases, the documentation of nuclear labeling for beta-catenin can assist in the recognition...
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
... nonmelanocytic neoplasms. Depending on the diagnostic problem (e.g., metastatic melanoma versus poorly differentiated carcinoma, lymphoma, or sarcoma) a set of antibodies to melanocytic differentiation antigens, as well as epithelial, lymphoid, and mesenchymal markers, may be necessary for a precise diagnosis...
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
... Spitz tumor is of practical use because it refers to a diagnostic dilemma: the pathologist is not sure whether the lesion is a benign nevus with unusual or atypical microscopic features or a Spitz (or spitzoid) melanoma ( 32 , 33 ). There is significant interobserver variability in the use of AST...
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
... sensitivity ( 22 ). Similar limitations in test sensitivity apply to contemporary gene expression arrays ( 23 ). DIFFERENTIAL DIAGNOSIS DM poses a significant diagnostic pitfall for pathologists ( 24 ). It may be confused with desmoplastic nevi or benign fibrosing nonmelanocytic lesions, such as a scar...
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
... to the large epithelioid tumor cells of the melanoma. This category of nodular melanoma, i.e., the group of primary dermal melanomas, is relevant for the potential diagnostic confusion with locally recurrent or metastatic melanoma. This distinction often can only be made by clinicopathologic correlation...
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
... with a melanocytic nevus. Tumors may be pigmented or amelanotic. At the time of diagnosis, most lesions are larger than 7 mm in diameter. For the diagnosis of many pigmented acral melanomas, the ABCDE (asymmetry, irregular border, color variation, diameter over 6 mm, evolving) clinical diagnostic criteria...
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
... be confused with lentigo simplex, macular seborrheic keratosis, or pigmented actinic keratosis, but the most important diagnostic issue is its distinction from lentigo maligna melanoma in situ. The latter may clinically evolve in association with or simulate the appearance of a solar lentigo. Melanoma in situ...
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
... melanocytes are best distinguished from melanophages by nuclear labeling for SOX10, or after bleaching, using an immunostain for HMB-45 with a red chromogen. Immunohistochemistry can be useful for diagnostic purposes. For the distinction of a sclerosing BN from desmoplastic melanoma, the combination of strong...
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
... differentiation antigens can help distinguish isolated tumor cells in the superficial dermis from inflammatory cells ( fig. 13-16 ). SOX10 and S-100 protein are essential for the recognition of desmoplastic melanoma. There is, however, potential for diagnostic pitfalls. Melanin pigment (melanophages) may lead...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-10
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
.... For diagnostically difficult cases immunohistochemical (e.g., PRAME expression) and/or ancillary cytogenetic studies are used for further characterization. If the atypical cell population is small, FISH analysis is preferable to CGH or SNP array so that cytogenetic aberrations can be directly correlated...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-03
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... by a biphenotypic population of melanocytes: one (the nevus population) displaying bland conventional nevus features, while the melanoma cells are cytologically more atypical and architecturally disordered. The greatest diagnostic challenge is the distinction of a mitotically active nevus from a nevoid melanoma...