DermPath-India

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 Dr Sampurna Roy MD

          

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              Desmoplastic/Spindle cell
/Neurotropic Melanoma

       Dr. Sampurna Roy  MD

 
 Melanocytic Tumours

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
 

             
Nevus may  recur following inadequate excision  (shave biopsy of the lesion) or after chronic irritation or laser therapy.

Almost 50% of the lesions recur within 6 months.

Microscopic features:

i) The lesion displays lentiginous and junctional theques above the dermal scar.

ii) There are no epidermal ridges. 

iii)Dermal fibrosis is present due to previous operative procedure.

iv)Nevus cells are present in the deep dermis and at the edge of the scar.

v) In the scarred area a few scattered nevus cells (like fibroblasts) are present.

vi) Usually HMB45 stains  more prominently  in the recurrent naevi than the original lesion.  Case Link: click here

                       

 
Common and uncommon variants of melanocytic naevi. Pathology. 2004 Oct;36(5):396-403.

Numerous variants of melanocytic naevi have been described. Their main pathological significance lies in their distinction from melanoma, as well as being precursors and risk markers for melanoma. Various degrees of atypia such as cytological atypia, architectural disorder and pagetoid spread (pagetoid melanocytosis) may be present in naevi and need to be recognised as appropriate for the subtype. As well as the distinction from melanoma, naevi must be differentiated from atypical lesions, such as atypical Spitz tumours, which do not fulfil all the criteria of melanoma, may be benign or malignant and have been called 'melanocytic tumours of unknown malignant potential'. The diagnostic grey area also includes a group of benign atypical naevi which are difficult to subclassify into specific entities. In this paper naevi are divided into: firstly, the common acquired group with a brief discussion of junctional, compound and intradermal naevi, minor variants such as halo and balloon naevi and the major variants that may cause problems -- dysplastic naevi, naevi of special sites, recurrent naevi and Spitz naevi; secondly, congenital naevi; thirdly, blue naevi and related lesions (dermal melanocytoses); and finally, combined naevi. The emphasis is on diagnostic pathological features and the differential diagnosis with melanoma.

Click on the images
 

Pigmented melanocytic lesions causing diagnostic problems

Prognostic parameters of melanoma

Lentigo maligna melanoma

Superficial spreading  melanoma

Nodular melanoma

Acral lentiginous melanoma

Desmoplastic /Spindle cell /Neurotropic melanoma

Naevoid melanoma

Balloon cell melanoma

 


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