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Pathology of Nodular Melanoma

"Second most common subtype of melanoma"

Dr Sampurna Roy MD              

Dermatopathology Quiz Case 136 

Diagnosis: Nodular Melanoma





Nodular melanoma represents 15% of all melanomas and is the second most common subtype of melanoma.

The most common sites for nodular melanoma are the trunk, head, and neck.

The patients are usually in the fifth decade of life.

It is more common for nodular melanoma to begin in normal skin rather than in a pre-existing lesion.

Macroscopically, the lesion presents as a nodular, polypoid or pedunculated  dark brown or blue black lesion.

Lesion may also present as an amelanotic nodule.

Microscopic features: 


In nodular melanoma there is minimal or no radial growth phase. 

Histologically, the dermal component is usually composed of epithelioid type of cells.

There is epidermal invasion directly over the dermal component.

No adjacent intraepidermal component is seen.


Further reading:

Nestin expression is associated with aggressive cutaneous melanoma of the nodular type.

Diagnostic accuracy of malignant melanoma according to subtype.

Pigmented nodular melanoma.

CD34 expression in primary cutaneous malignant melanoma: apropos of a case and review of the aberrant melanoma phenotype.

Melanoma simulating malignant soft tissue tumour.

BRAF and NRAS mutations are frequent in nodular melanoma but are not associated with tumor cell proliferation or patient survival.

Breslow depth of cutaneous melanoma: impact of factors related to surveillance of the skin, including prior skin biopsies and family history of melanoma.






Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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