Difference between revisions of "Atypical lentiginous nevus"
		
		
		
		
		
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|  (+SO section) |  (→External links:  twdak) | ||
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| | Width      = | | Width      = | ||
| | Caption    =   | | Caption    =   | ||
| | Micro      = elongated rete ridges (key feature) | | Micro      = elongated rete ridges (key feature), diffuse (non-lamellar) superficial dermal fibrosis, mild-to-moderated cytologic atypia | ||
| | Subtypes   = | | Subtypes   = | ||
| | LMDDx      = [[dysplastic nevus]], [[melanoma in situ]] | | LMDDx      = [[dysplastic nevus]], [[melanoma in situ]] | ||
| Line 12: | Line 12: | ||
| | Molecular  = | | Molecular  = | ||
| | IF         = | | IF         = | ||
| | Gross      = | | Gross      =   | ||
| | Grossing   = | | Grossing   = | ||
| | Site       = | | Site       = [[skin]] | ||
| | Assdx      = | | Assdx      = [[malignant melanoma]] | ||
| | Syndromes  = | | Syndromes  = | ||
| | Clinicalhx = elderly population | |||
| | Signs      = | | Signs      = | ||
| | Symptoms   = | | Symptoms   = | ||
| Line 25: | Line 26: | ||
| | Prognosis  = | | Prognosis  = | ||
| | Other      = | | Other      = | ||
| | ClinDDx    = | | ClinDDx    = [[melanoma]] | ||
| }} | }} | ||
| '''Atypical lentiginous nevus''', also '''atypical lentiginous nevus of the elderly''', is a [[melanocytic lesion]] associated with old age and melanoma. | '''Atypical lentiginous nevus''', also '''atypical lentiginous nevus of the elderly''', is a [[melanocytic lesion]] associated with old age and melanoma. It may be abbreviated '''ALN'''. | ||
| It can be considered a type of [[dysplastic nevus]].<ref name=pmid10911797>{{Cite journal  | last1 = Edwards | first1 = SL. | last2 = Blessing | first2 = K. | title = Problematic pigmented lesions: approach to diagnosis. | journal = J Clin Pathol | volume = 53 | issue = 6 | pages = 409-18 | month = Jun | year = 2000 | doi =  | PMID = 10911797 }}</ref><ref>{{Cite journal  | last1 = Kossard | first1 = S. | title = Atypical lentiginous junctional naevi of the elderly and melanoma. | journal = Australas J Dermatol | volume = 43 | issue = 2 | pages = 93-101 | month = May | year = 2002 | doi =  | PMID = 11982564 }}</ref> | It can be considered a type of [[dysplastic nevus]].<ref name=pmid10911797>{{Cite journal  | last1 = Edwards | first1 = SL. | last2 = Blessing | first2 = K. | title = Problematic pigmented lesions: approach to diagnosis. | journal = J Clin Pathol | volume = 53 | issue = 6 | pages = 409-18 | month = Jun | year = 2000 | doi =  | PMID = 10911797 }}</ref><ref>{{Cite journal  | last1 = Kossard | first1 = S. | title = Atypical lentiginous junctional naevi of the elderly and melanoma. | journal = Australas J Dermatol | volume = 43 | issue = 2 | pages = 93-101 | month = May | year = 2002 | doi =  | PMID = 11982564 }}</ref> | ||
| Line 39: | Line 40: | ||
| ==Microscopic== | ==Microscopic== | ||
| Features:<ref name=pmid22421501>{{Cite journal  | last1 = Agustí-Mejias | first1 = A. | last2 = Messeguer Badia | first2 = F. | last3 = García Ruiz | first3 = R. | last4 = Oliver Martínez | first4 = V. | last5 = Alegre de Miquel | first5 = V. | title = [Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases]. | journal = Actas Dermosifiliogr | volume = 103 | issue = 5 | pages = 394-400 | month = Jun | year = 2012 | doi = 10.1016/j.ad.2011.10.006 | PMID = 22421501 }}</ref> | Features:<ref name=pmid22421501>{{Cite journal  | last1 = Agustí-Mejias | first1 = A. | last2 = Messeguer Badia | first2 = F. | last3 = García Ruiz | first3 = R. | last4 = Oliver Martínez | first4 = V. | last5 = Alegre de Miquel | first5 = V. | title = [Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases]. | journal = Actas Dermosifiliogr | volume = 103 | issue = 5 | pages = 394-400 | month = Jun | year = 2012 | doi = 10.1016/j.ad.2011.10.006 | PMID = 22421501 | URL = http://www.actasdermo.org/en/atypical-lentiginous-nevus-a-clinical/articulo/90149637/?pubmed=true }}</ref> | ||
| *Elongated rete ridges - '''key feature'''. | *Elongated rete ridges - '''key feature'''. | ||
| *Superficial dermal fibrosis, diffuse (non-lamellar) - '''important'''. | *Superficial dermal fibrosis, diffuse (non-lamellar) - '''important'''. | ||
| *Mild-to- | *Mild-to-moderate cytologic atypia, focal. | ||
| Notes:<ref name=pmid22421501/> | |||
| *Rarely dermal nests. | |||
| *Mild-to-moderate inflammation. | |||
| *Mitoses - never. | |||
| *[[Solar elastosis]] - mild-to-moderate. | |||
| DDx:<ref name=pmid22421501/> | DDx:<ref name=pmid22421501/> | ||
| Line 48: | Line 55: | ||
| *[[Dysplastic nevus]] - lamellar fibrosis. | *[[Dysplastic nevus]] - lamellar fibrosis. | ||
| *[[Lentigo simplex]]. | *[[Lentigo simplex]]. | ||
| *[[Lentigo maligna]]. | *[[Lentigo maligna]] - more atypia, upward migration of melanocytes, occasional mitoses. | ||
| *[[Solar lentigo]]. | *[[Solar lentigo]] - [[solar elastosis]]. | ||
| *[[Lentiginous nevus]]. | *[[Lentiginous nevus]]. | ||
| ===Images=== | |||
| *[http://www.actasdermo.org/imatges/403/403v103n05/grande/403v103n05-90149637fig2.jpg ALN (actasdermo.org)].<ref name=pmid22421501/> | |||
| ==Sign out== | ==Sign out== | ||
| Line 57: | Line 67: | ||
| - ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. | - ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. | ||
| -- COMPLETELY EXCISED, (CLEARANCE 2 MM). | -- COMPLETELY EXCISED, (CLEARANCE 2 MM). | ||
| </pre> | |||
| <pre> | |||
| SKIN LESION, CENTRAL BACK, SHAVE EXCISION: | |||
| - ATYPICAL LENTIGINOUS NEVUS. | |||
| -- COMPLETELY EXCISED, (CLEARANCE 2 MM). | |||
| -- MILD CYTOLOGIC ATYPIA. | |||
| </pre> | </pre> | ||
| Line 70: | Line 87: | ||
| ==References== | ==References== | ||
| {{Reflist|2}} | {{Reflist|2}} | ||
| ==External links== | |||
| *[http://www.dermpedia.org/dermpedia-textbook/compound-nevus-with-atypia Compound nevus with atypia (dermpedia.org)]. | |||
| [[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
| [[Category:Dermatopathology]] | [[Category:Dermatopathology]] | ||
Latest revision as of 03:29, 11 September 2013
| Atypical lentiginous nevus | |
|---|---|
| Diagnosis in short | |
|  | |
| LM | elongated rete ridges (key feature), diffuse (non-lamellar) superficial dermal fibrosis, mild-to-moderated cytologic atypia | 
| LM DDx | dysplastic nevus, melanoma in situ | 
| Site | skin | 
|  | |
| Associated Dx | malignant melanoma | 
| Clinical history | elderly population | 
| Clin. DDx | melanoma | 
Atypical lentiginous nevus, also atypical lentiginous nevus of the elderly, is a melanocytic lesion associated with old age and melanoma. It may be abbreviated ALN.
It can be considered a type of dysplastic nevus.[1][2]
General
- Associated with malignant melanoma.[3]
Gross
- Pigmented lesion.
- Size: 0.3-1.0 cm.[4]
Microscopic
Features:[4]
- Elongated rete ridges - key feature.
- Superficial dermal fibrosis, diffuse (non-lamellar) - important.
- Mild-to-moderate cytologic atypia, focal.
Notes:[4]
- Rarely dermal nests.
- Mild-to-moderate inflammation.
- Mitoses - never.
- Solar elastosis - mild-to-moderate.
DDx:[4]
- Lentiginous melanoma.
- Dysplastic nevus - lamellar fibrosis.
- Lentigo simplex.
- Lentigo maligna - more atypia, upward migration of melanocytes, occasional mitoses.
- Solar lentigo - solar elastosis.
- Lentiginous nevus.
Images
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SKIN LESION, CENTRAL BACK, SHAVE EXCISION: - ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. -- COMPLETELY EXCISED, (CLEARANCE 2 MM).
SKIN LESION, CENTRAL BACK, SHAVE EXCISION: - ATYPICAL LENTIGINOUS NEVUS. -- COMPLETELY EXCISED, (CLEARANCE 2 MM). -- MILD CYTOLOGIC ATYPIA.
Micro
The sections show hair-bearing skin with elongated rete ridges with focal bridging, and lentiginous, mildly atypical melanocytes. Non-lamellar superficial dermal fibrosis is present. No upward scatter of melanocytes is apparent.
The lesion is completely excised in the plane of section.
See also
References
- ↑ Edwards, SL.; Blessing, K. (Jun 2000). "Problematic pigmented lesions: approach to diagnosis.". J Clin Pathol 53 (6): 409-18. PMID 10911797.
- ↑ Kossard, S. (May 2002). "Atypical lentiginous junctional naevi of the elderly and melanoma.". Australas J Dermatol 43 (2): 93-101. PMID 11982564.
- ↑ Kossard, S.; Commens, C.; Symons, M.; Doyle, J. (1991). "Lentinginous dysplastic naevi in the elderly: a potential precursor for malignant melanoma.". Australas J Dermatol 32 (1): 27-37. PMID 1930003.
- ↑ 4.0 4.1 4.2 4.3 4.4 Agustí-Mejias, A.; Messeguer Badia, F.; García Ruiz, R.; Oliver Martínez, V.; Alegre de Miquel, V. (Jun 2012). "[Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases].". Actas Dermosifiliogr 103 (5): 394-400. doi:10.1016/j.ad.2011.10.006. PMID 22421501.