DermPath-India

     Site created by

 Dr Sampurna Roy MD

          

http://www.histopathology-india.net/dermpath.htm

  

                      HISTOPATHOLOGY INDIA.COM

             Desmoplastic/Spindle cell
/Neurotropic Melanoma

   Dr. Sampurna Roy  MD

 

  Gastrointestinal Stromal Tumour

    

http://www.histopathology-india.MelanocyticTumours.htm

May 2009

 

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Melanocytic tumours
              
1. Acquired Melanocytic Naevus

Ancient Naevus
Halo naevus
Balloon cell naevus
Combined Naevus
Recurrent melanocytic naevus

                   
2. Spindle and epithelioid cell naevi

Spitz naevus
Pigmented spindle cell naevus

3. Blue naevi

Common blue naevus 
Cellular blue naevus


4. Dermal melanocytoses

Naevus of Ota

Naevus of Ito  
Mongolian spot  

5. Congenital melanocytic naevi

6. Dysplastic melanocytic naevi
Pigmented melanocytic lesions causing diagnostic problems

Prognostic parameters of melanoma

Lentigo maligna melanoma

Superficial spreading melanoma

Nodular melanoma

Acral lentiginous melanoma

Naevoid melanoma

                     
Ancient melanocytic nevus may mimick malignant melanoma.

The name 'ancient' is used because it shares numerous features with 'ancient schwannoma'

Site: Found most commonly on the face of older persons.

Gross: The neoplasm is usually a dome-shaped, skin-colored or reddish brown papule.

Microscopic features:

Image link: 

Exo-endophytic, mostly intradermal proliferations of two populations of melanocytes .

 i) large melanocytes with pleomorphic; may resemble those of the epithelioid type of Spitz's nevus.

 ii) small monomorphous melanocytes.

A few mitotic figures may be present in a particular section. Epidermis is usually uninvolved ; sometimes there may be a junctional component.

If the mitotic figures are in the base of the lesion, are atypical, or numerous, the diagnosis is almost certainly that of melanoma.

Other important findings : Degenerative changes that include thrombi, zones of hemorrhage, pseudo- angiomatous changes, thick rims of sclerosis around dilated venules, fibrosis, and mucin.

Ancient nevi are often misdiagnosed as melanoma arising in an intra-dermal nevus.

                     

Abstract :

Ancient melanocytic nevus. Semin Diagn Pathol. 1998 Aug;15(3):210-5.

Ancient melanocytic nevus is an example of a simulator of malignant melanoma, designated ancient because it shares numerous features with ancient schwannoma. Knowledge of the histopathologic characteristics of this benign melanocytic neoplasm should enable pathologists to avoid overdiagnosis of it as melanoma arising in the intradermal portion of a nevus. Ancient nevi are found most commonly on the face of older persons. The neoplasm is usually a dome-shaped, skin-colored or reddish brown papule, usually with features of a Miescher's nevus. Histopathologically, ancient nevi are exoendophytic, mostly intradermal proliferations of two populations of melanocytes: one with large pleomorphic nuclei and the other with small monomorphous ones. The large melanocytes may resemble those of the epithelioid type of Spitz's nevus. A few mitotic figures may be present in a particular section. The epidermis usually is uninvolved, but sometimes there may be a junctional component. Other important findings are degenerative changes that include thrombi, zones of hemorrhage, pseudoangiomatous changes, thick rims of sclerosis around dilated venules, fibrosis, and mucin. Ancient nevi frequently are misdiagnosed as melanoma arising in an intradermal nevus.

Visit: Desmoplastic /Spindle cell /Neurotropic  melanoma ; Balloon cell melanoma.

                        

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