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Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-09
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... deep downward growth to the reticular dermis and/or superficial subcutis, often displaying a wedge (inverted triangle-like) shape ( figs. 9-1 – 9-3 ) ( 1 – 7 ). However, small superficial variants exist, in which the tumor cells are confined to the upper and mid reticular dermis ( fig. 9-4 ). Fascicles...
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
..., circumscribed, small (typically less than 5 mm in diameter) macules ( fig. 3-1 ). Lesions vary in pigmentation from light to dark brown, but each lesion is fairly homogeneous in color. Dermoscopically, junctional nevi usually have a reticulated pattern, which reflects the accumulation of the pigment along...
Images
ACRAL MELANOMA  Asymmetric silhouette of the heavily pigmented ulcerated me...
Published: 01 February 2024
ACRAL MELANOMA Figure 14-9 ACRAL MELANOMA Asymmetric silhouette of the heavily pigmented ulcerated melanoma (seen in fig. 14-6 ). More about this image found in ACRAL MELANOMA Asymmetric silhouette of the heavily pigmented ulcerated me...
Images
DEEP PENETRATING NEVUS  A: The tumor cells are diffusely immunoreactive for...
Published: 01 February 2024
DEEP PENETRATING NEVUS Figure 9-8 DEEP PENETRATING NEVUS A: The tumor cells are diffusely immunoreactive for beta-catenin (same lesion as illustrated in fig. 9-3 ). B: The tumor cells display nuclear expression of beta-catenin. More about this image found in DEEP PENETRATING NEVUS A: The tumor cells are diffusely immunoreactive for...
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
.... They may involve any aspect of the acral region. Except for congenital nevi, most acral nevi measure less than 6 mm in diameter (median, 2 mm) ( figs. 5-1 , 5-2 ). ACRAL NEVUS OF THE FOOT Figure 5-1 ACRAL NEVUS OF THE FOOT A: Pigmented macule on the lateral aspect of the sole of the foot (arrow). B...
Images
COMBINED DEEP PENETRATING NEVUS  A: Silhouette of a congenital nevus with a...
Published: 01 February 2024
COMBINED DEEP PENETRATING NEVUS Figure 10-2 COMBINED DEEP PENETRATING NEVUS A: Silhouette of a congenital nevus with a dual population of conventional and pigmented melanocytes. B: Juxtaposition of the pigmented spindle and epithelioid melanocytes (*) and conventional type B (arrow) melanocytes ... More about this image found in COMBINED DEEP PENETRATING NEVUS A: Silhouette of a congenital nevus with a...
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
... or reticulated melanotic macule ( 2 ). Microscopic Findings. Solar lentigo is histopathologically characterized by melanin pigment deposition in basilar keratinocytes. Often there is associated slight epidermal hyperplasia, resulting in elongated, club-shaped rete ridges ( fig. 1-1 ). As rete ridges become...
Book Chapter
Series: Atlases of Tumor and Non-Tumor Pathology, Series 5
Volume: 19
Published: 01 February 2024
10.55418/9781933477428-02
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... by somatic mosaicism in NRAS  Proliferative nodules show copy number changes of whole chromosomes CLINICAL FEATURES A CMN can vary in size, color, shape, and texture. The color may be reddish, tan, light brown, dark brown, bluish, or near black ( fig. 2-1 ). A lesion may be flat or raised...
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
10.55418/9781933477428-04
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... be a macular component. Also, at least three of the following parameters should be seen: an irregular peripheral border, a diameter of 5 mm or greater, variation in color, or erythema ( figs. 4-1 , 4-2 ). DYSPLASTIC NEVUS Figure 4-1 DYSPLASTIC NEVUS A: Multiple red and brown lesions are present...
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 context with a history of change ( fig. 12-1 ) ( 6 ). Dermoscopic findings, such as an atypical pigment network, streaks, irregular blotches, or peripheral brown structureless areas, assist in the diagnosis ( 7 ). A negative pigment network, atypical dots and globules, blue white structures, and atypical...
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
... is found between the primary site and regional lymph nodes, it is classified as a locoregional “in-transit” metastasis ( fig. 22-1 ). Cutaneous metastases located farther away beyond the regional node of the primary melanoma site are called “distant” metastases. MELANOMA IN-TRANSIT METASTASIS Figure 22-1...
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
... is recognized as a distinctly different nodule with high cellularity and epithelioid atypia ( fig. 18-1 ). The melanoma is entirely intradermal, with no associated in situ component in the epidermis or adnexal structures. MELANOMA ARISING IN ASSOCIATION WITH A BLUE NEVUS Figure 18-1 MELANOMA ARISING...
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
... usually manifest as a dome-shaped papule, small plaque, or macule ( figs. 7-1 – 7-3 ). They often come up quickly. Their color ranges from tan, pink, and red to light or dark brown. SPITZ NEVUS Figure 7-1 SPITZ NEVUS A: The nevus presents as a circumscribed and symmetric pink papule on the cheek...
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
... and/or epithelioid melanocytes, or display other features associated with Spitz tumors (e.g., clefts between epidermis and junctional nests, junctional dull pink globules). Spitzoid melanomas parallel the spectrum of Spitz nevi. They may be amelanotic ( fig. 19-1 ) or show at least focal pigmentation ( fig. 19-2...
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
10.55418/9781933477428-06
ISBN-10: 1-933477-42-3
ISBN: 978-1-933477-42-8
... period of growth, persistent nevi usually stabilize. Microscopic Findings. A persistent nevus typically displays a trizonal pattern ( fig. 6-1 – 6-3 ) ( 6 , 14 , 16 ). There is a proliferation of melanocytes within the epidermis, an underlying scar, and in some cases a nevus cell population...
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
... Combined melanocytic nevi occur at any age and any anatomic site. They are more commonly found in younger individuals ( 1 – 4 ). Most lesions come to clinical attention with a history of change. The change may reflect a darkening ( fig. 10-1 ), as in the case of a combined deep penetrating nevus, or change...
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
... have a large epithelioid appearance and display clear or foamy cytoplasm ( fig. 21-1 ). Balloon cell changes are most often associated with, but not restricted to, superficial spreading melanomas. In some tumors, all or nearly all tumor cells display balloon cell features, while in others only some...
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
... of the papillary dermis by tumor cells, elongated thin rete ridges, and mitoses ( figs. 17-1 – 17-7 ). Another diagnostic clue is the presence of a row of multiple, dense cellular aggregates surrounded by small collarettes of elongated rete ridges. Such an arrangement gives rise to a “puffy shirt”-like appearance...