Melanocytic lesions - Revision history

Michael: /* Desmoplastic melanocytic nevus */ +nodal nevus

2021-02-11T18:47:55Z

Desmoplastic melanocytic nevus: +nodal nevus

← Older revision		Revision as of 18:47, 11 February 2021
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	**Should stain approximally the same number of cells as Melan A.		**Should stain approximally the same number of cells as Melan A.
	*Ki-67 -- only rare cells.		*Ki-67 -- only rare cells.

			==Nodal nevus==
			*AKA ''nevus in lymph node'' and ''benign nevus cells in lymph node''.
			{{Main\|Nodal nevus}}

	=Miscellaneous=		=Miscellaneous=

Michael: /* Microscopic */

2016-08-26T16:47:40Z

Microscopic

← Older revision		Revision as of 16:47, 26 August 2016
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	**Classically at the tips of the rete ridges.		**Classically at the tips of the rete ridges.
	*No (melanocyte) nuclear atypia.		*No (melanocyte) nuclear atypia.
	*Solar damage ([[solar elastosis]]).<ref name=pmid19536147/>		*Solar damage ([[solar elastosis]]).<ref name=pmid19536147>{{Cite journal \| last1 = Hafner \| first1 = C. \| last2 = Stoehr \| first2 = R. \| last3 = van Oers \| first3 = JM. \| last4 = Zwarthoff \| first4 = EC. \| last5 = Hofstaedter \| first5 = F. \| last6 = Klein \| first6 = C. \| last7 = Landthaler \| first7 = M. \| last8 = Hartmann \| first8 = A. \| last9 = Vogt \| first9 = T. \| title = The absence of BRAF, FGFR3, and PIK3CA mutations differentiates lentigo simplex from melanocytic nevus and solar lentigo. \| journal = J Invest Dermatol \| volume = 129 \| issue = 11 \| pages = 2730-5 \| month = Nov \| year = 2009 \| doi = 10.1038/jid.2009.146 \| PMID = 19536147 }}</ref>

	Notes:		Notes:

Michael: /* Lentigo simplex */ split out

2016-08-26T16:37:28Z

Lentigo simplex: split out

← Older revision		Revision as of 16:37, 26 August 2016
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	=Lentiginous melanocytic lesions=		=Lentiginous melanocytic lesions=
	==Lentigo simplex==		==Lentigo simplex==
	*[[AKA]] ''simple lentigo''.<ref>URL: [http://www.dermnetnz.org/lesions/lentigo-simplex.html http://www.dermnetnz.org/lesions/lentigo-simplex.html]. Accessed on: 27 March 2013.</ref>		{{Main\|Lentigo simplex}}
	~~===General===~~
	*Benign.
	*Usually <40 years old.

	~~Fits into the larger category of ''lentiginous melanocytic proliferations'' - these include:<ref name=Ref_Derm438>~~{{~~Ref Derm~~\|~~438}}</ref>~~
	*[[Solar lentigo]].
	*Lentigo simplex.
	*[[Lentiginous nevus]].
	*Lentiginous [[melanoma in situ]].

	Associated syndromes:<ref name=dermamin_ls>URL: [http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html]. Accessed on: 17 December 2012.</ref>
	*[[Peutz-Jeghers syndrome]].
	*[[LEOPARD syndrome]].
	*[[LAMB syndrome]].

	~~===Gross===~~
	*Small flat pigmented lesion.<ref name=Ref_WMSP498>{{Ref WMSP\|498}}</ref>

	~~DDx - clinical:~~
	*[[Melanocytic nevus]].<ref name=pmid19536147>{{Cite journal \| last1 = Hafner \| first1 = C. \| last2 = Stoehr \| first2 = R. \| last3 = van Oers \| first3 = JM. \| last4 = Zwarthoff \| first4 = EC. \| last5 = Hofstaedter \| first5 = F. \| last6 = Klein \| first6 = C. \| last7 = Landthaler \| first7 = M. \| last8 = Hartmann \| first8 = A. \| last9 = Vogt \| first9 = T. \| title = The absence of BRAF, FGFR3, and PIK3CA mutations differentiates lentigo simplex from melanocytic nevus and solar lentigo. \| journal = J Invest Dermatol \| volume = 129 \| issue = 11 \| pages = 2730-5 \| month = Nov \| year = 2009 \| doi = 10.1038/jid.2009.146 \| PMID = 19536147 }}~~</ref>~~

	~~===Microscopic===~~
	~~Features:<ref name=Ref_WMSP498>{{Ref WMSP\|498}}</ref>~~
	*Melanocytes in epidermis only.
	**Melanocytes basally located (normal location) with hyperpigmentation.
	*No melanocytic nests.
	*+/-Mild/moderate elongation of the rete ridges.<ref name=pmid19536147/>

	~~DDx:<ref name=humpath_ls/>~~
	*[[Solar lentigo]] - solar elastosis, usu. in sun exposed areas.
	*[[Ephelis]] (freckle) - change with UV light exposure.
	*Melanotic macule.
	*[[Lentiginous nevus]] - has melanocytic nests.

	~~====Images====~~
	*[http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html Lentigo simplex - several images (dermamin.com)].<ref name=dermamin_ls/>
	*[http://www.humpath.com/IMG/jpg/lentigo_simplex_20x.jpg Lentigo simplex (humpath.com)].<ref name=humpath_ls>URL: [http://www.humpath.com/?lentigo-simplex http://www.humpath.com/?lentigo-simplex]. Accessed on: 17 December 2012.</ref>
	~~<gallery>~~
	~~Image:Skin_Tumors-171.jpg \| Simple lentigo. (WC)~~
	~~</gallery>~~

	~~===Sign out===~~
	~~<pre>~~
	~~SKIN LESION, LEFT ABDOMEN, BIOPSY:~~
	~~- SIMPLE LENTIGO, COMPLETELY EXCISED IN THE PLANE OF SECTION.~~
	~~</pre>~~

	~~<pre>~~
	~~SKIN LESION, LEFT ABDOMEN, BIOPSY:~~
	~~- BENIGN SIMPLE LENTIGO.~~
	~~</pre>~~

	~~====Micro====~~
	The sections show skin with increased numbers of small pigmented melanocytes at the dermal-epidermal junction. The rete ridges are mildly elongated. No solar damage is apparent. No dermal melanocytes are identified. No melanocytic nests are identified. No nuclear atypia is apparent.

	==Solar lentigo==		==Solar lentigo==

Michael at 16:38, 15 April 2016

2016-04-15T16:38:09Z

← Older revision		Revision as of 16:38, 15 April 2016
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	[[Image:Blue nevus - intermed mag.jpg\|thumb\|right\|A melanocytic lesion (blue nevus). [[H&E stain]]. (WC/Nephron)]]		[[Image:Blue nevus - intermed mag.jpg\|thumb\|right\|A melanocytic lesion ([[blue nevus]]). [[H&E stain]]. (WC/Nephron)]]
	'''Melanocytic lesions''' are commonly encountered in [[dermatopathology]] and an area which causes some difficulty, i.e. it is hard to decide in some cases whether a lesion is benign (e.g. [[Spitz nevus]]) or malignant ([[malignant melanoma]]).		'''Melanocytic lesions''' are commonly encountered in [[dermatopathology]] and an area which causes some difficulty, i.e. it is hard to decide in some cases whether a lesion is benign (e.g. [[Spitz nevus]]) or malignant ([[malignant melanoma]]).

Michael at 16:37, 15 April 2016

2016-04-15T16:37:57Z

← Older revision		Revision as of 16:37, 15 April 2016
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			[[Image:Blue nevus - intermed mag.jpg\|thumb\|right\|A melanocytic lesion (blue nevus). [[H&E stain]]. (WC/Nephron)]]
	'''Melanocytic lesions''' are commonly encountered in [[dermatopathology]] and an area which causes some difficulty, i.e. it is hard to decide in some cases whether a lesion is benign (e.g. [[Spitz nevus]]) or malignant ([[malignant melanoma]]).		'''Melanocytic lesions''' are commonly encountered in [[dermatopathology]] and an area which causes some difficulty, i.e. it is hard to decide in some cases whether a lesion is benign (e.g. [[Spitz nevus]]) or malignant ([[malignant melanoma]]).

Michael: /* See also */

2016-04-15T16:36:34Z

Michael: /* Acral nevus */

2016-03-12T20:08:35Z

Acral nevus

← Older revision		Revision as of 20:08, 12 March 2016
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	==Acral nevus==		==Acral nevus==
	*[[AKA]] ''melanocytic nevus with intraepidermal ascent of cells'' (MANIAC).		*[[AKA]] ''melanocytic nevus with intraepidermal ascent of cells'' ([[MANIAC]]).
	*[[AKA]] ''volar nevus''.		*[[AKA]] ''volar nevus''.
	{{Main\|Acral nevus}}		{{Main\|Acral nevus}}

Michael: /* Acral nevus */ split out

2015-09-08T14:14:07Z

Acral nevus: split out

← Older revision		Revision as of 14:14, 8 September 2015
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	*[[AKA]] ''melanocytic nevus with intraepidermal ascent of cells'' (MANIAC).		*[[AKA]] ''melanocytic nevus with intraepidermal ascent of cells'' (MANIAC).
	*[[AKA]] ''volar nevus''.		*[[AKA]] ''volar nevus''.
	~~===General===~~		{{Main\|Acral nevus}}
	*Palms ''or'' soles.

	~~Note:~~
	*''Volar'' refers to the palmar aspect ''or'' plantar aspect.<ref>URL: [http://www.medterms.com/script/main/art.asp?articlekey=9907 http://www.medterms.com/script/main/art.asp?articlekey=9907]. Accessed on: 14 January 2013.</ref>

	~~===Gross===~~
	*Pigmented lesion.

	~~Note:~~
	*Should be bisected perpendicular to the dermatoglyphs (ridges).<ref name=pmid22703907/>
	**Lesions sectioned parallel to the ridges (on microscopy) may appear to have confluent junctional nests (leading to the diagnosis of melanoma).
	~~===Microscopic===~~
	~~Features:~~
	*Acral skin:
	**Thick stratum corneum (hyperkeratotic).
	**Thick stratum spinosum (acanthotic).
	*Nevus with intraepidermal ascent of cells.
	**May be referred to as ''Pagetoid scatter''.
	**Should '''not''' be present at the edge of the lesion - '''key feature'''.<ref name=pmid22703907/>

	~~Notes:~~
	*Intraepidermal ascent of cells is usually suggestive of melanoma.
	**In acral sites (esp. at the centre of a lesion) the criteria are relaxed, i.e. this is considered benign for this site.
	*Nests in the ridges raise the suspicion of melanoma.
	**Memory device "ridges are risky, furrows are fine".<ref name=pmid22703907>{{~~Cite journal~~ \| last1 = Elston \| first1 = D. \| title = Practical advice regarding problematic pigmented lesions. \| journal = J Am Acad Dermatol \| volume = 67 \| issue = 1 \| pages = 148-55 \| month = Jul \| year = 2012 \| doi = 10.1016/j.jaad.2012.04.006 \| PMID = 22703907 }}~~</ref>~~

	~~DDx:~~
	*Acral lentiginous [[melanoma]].

	==Dysplastic melanocytic nevus==		==Dysplastic melanocytic nevus==

Michael: /* See also */

2014-07-27T06:05:20Z

Michael: /* Sign out */ split out

2014-04-20T00:11:43Z

Sign out: split out

← Older revision		Revision as of 00:11, 20 April 2014
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	====Intradermal melanocytic nevus====		====Intradermal melanocytic nevus====
	~~<pre>~~		{{Main\|Intradermal nevus}}
	~~SKIN LESION, BACK, PUNCH BIOPSY:~~
	~~- BENIGN INTRADERMAL NEVUS.~~
	~~</pre>~~

	~~=====Adipocytes present=====~~
	~~<pre>~~
	~~SKIN LESION, BACK, PUNCH BIOPSY:~~
	~~- BENIGN INTRADERMAL NEVUS WITH MATURE ADIPOCYTES.~~
	~~</pre>~~

	~~=====Clinically suspicious=====~~
	~~<pre>~~
	~~SKIN LESION, LEFT UPPER ARM, PUNCH BIOPSY:~~
	~~- BENIGN INTRADERMAL NEVUS, INCOMPLETELY EXCISED.~~

	~~COMMENT:~~
	~~HMB-45 marks very rare superficial cells. Ki-67 staining does not show apparent melanocyte~~
	~~staining. MITF marks the melanocytes and demonstrates maturation of the melanocytes with depth.~~
	~~</pre>~~

	~~=====Micro=====~~
	The sections show melanocytes in the dermis separated from the epidermis by a Grenz zone. The lesion is symmetrical in its architecture and pigment distribution. Superficially, melanocytes are in nests. Melanocytes mature with depth. No mitotic activity is appreciated.

	~~The lesion is completely excised in the plane of section.~~

	~~======IDN with congenital features======~~
	~~The sections show melanocytes in the dermis separated from the epidermis by a Grenz~~
	~~zone. The lesion is symmetrical in its architecture. Superficially, melanocytes are in~~
	~~nests. Melanocytes mature with depth and track along adnexal structures. No mitotic~~
	~~activity is appreciated. The lesion is incompletely excised in the plane of section.~~

	==Congenital-pattern nevus==		==Congenital-pattern nevus==

← Older revision		Revision as of 16:36, 15 April 2016
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	*[[Non-malignant skin disease]].		*[[Non-malignant skin disease]].
	*[[Pigmented lesions of the oral cavity]].		*[[Pigmented lesions of the oral cavity]].
			*[[Melanosis coli]].
			*[[Small bowel pseudomelanosis]].

	=References=		=References=

← Older revision		Revision as of 06:05, 27 July 2014
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	*[[Cytopathology]].		*[[Cytopathology]].
	*[[Non-malignant skin disease]].		*[[Non-malignant skin disease]].
			*[[Pigmented lesions of the oral cavity]].

	=References=		=References=