Junctional nevus: Difference between revisions

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==Evaluation==
==Evaluation==
===Swedish approach===
Review of '''clinical information''', mainly:<ref name=KVAST>{{cite web|author=Katarzyna Lundmark, Britta Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel|title=Histopatologisk bedömning och gradering av dysplastiskt nevus samt gränsdragning mot melanom in situ/melanom (Histopathological assessment and grading of dysplastic nevus and distinction from melanoma in situ/melanoma)|url=https://medlem.foreningssupport.se/foreningar/uploads/L15178/kvast/hud/Histopatologisk%20bedomning%20och%20gradering%20av%20dysplastiskt%20nevus%20samt%20gransdragning%20mot%20melanom%20in%20situ-melanom%2020150330.pdf|website=KVAST (Swedish Society of Pathology)|accessdate=2019-09-18}}</ref>
Review of '''clinical information''', mainly:<ref name=KVAST>{{cite web|author=Katarzyna Lundmark, Britta Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel|title=Histopatologisk bedömning och gradering av dysplastiskt nevus samt gränsdragning mot melanom in situ/melanom (Histopathological assessment and grading of dysplastic nevus and distinction from melanoma in situ/melanoma)|url=https://medlem.foreningssupport.se/foreningar/uploads/L15178/kvast/hud/Histopatologisk%20bedomning%20och%20gradering%20av%20dysplastiskt%20nevus%20samt%20gransdragning%20mot%20melanom%20in%20situ-melanom%2020150330.pdf|website=KVAST (Swedish Society of Pathology)|accessdate=2019-09-18}}</ref>
*Growth
*Growth

Revision as of 10:58, 20 September 2019

Author: Mikael Häggström [note 1]
Suspected dysplastic nevus (also called dysplastic melanocytic nevus).

Evaluation

Review of clinical information, mainly:[1]

  • Growth
  • Abnormal visual appearance
  • Size >10mm

Microscopy: Mandatory findings:[1]

  • Shoulder phenomenon, meaning that the extent of the dermal component is larger than the epidermal component.
  • Lentiginous proliferation, meaning an increased amount of melanocytes in the basal area, along rete pegs and sometimes between them.
  • Irregularly distributed nests of melanocytes.
  • Atypia

Classify into either of the following:

Parameter Low-grade dysplasia High-grade dysplasia Suspected melanoma in situ
Mild Moderate Severe
Structural
(Low
mag.)
Delimitation[1] Rarely diffuse Sometimes diffuse Often diffuse
Lentiginous proliferation[notes 1][1] Yes, along with rete pegs Yes, along with and focally between rete pegs Yes, along with and focally between rete pegs Yes partially continuous, multilayered
Bridging[1] Rarely Often
Confluent nests[1] Rarely Sometimes Often Often widespread
Pigment distribution[1] Regular Irregular
Suprabasal presence[1] (less than most superficial third of epidermis) No Yes Yes, multifocal
Pagetoid migration including superficial third of epidermis[1] No No Yes, in a maximum of 2 HPF centrally, but not peripherally

Yes, multifocal and/or in periphery

Cellular
(high
mag.)
Nuclear pleomorphism[2] Slight Prominent
Chromatin pattern[2] Usually thin Usually granular
Nucleolus[2] Usually inconspicuous Usually prominent
Histological regression[2][notes 2] Usually Usually not

Notes

  1. Lentiginous proliferation is proliferation along the basal layer of the epidermis
  2. Histological regression is one or more areas within a tumor in which neoplastic cells have disappeared or decreased in number. In this case, this means complete or partial disappearance from areas of the dermis (and occasionally from the epidermis), which have been replaced by fibrosis, accompanied by melanophages, new blood vessels, and a variable degree of inflammation.
    - Ribero, Simone; Gualano, Maria Rosaria; Osella-Abate, Simona; Scaioli, Giacomo; Bert, Fabrizio; Sanlorenzo, Martina; Balagna, Elena; Fierro, Maria Teresa; et al. (2015). "Association of Histologic Regression in Primary Melanoma With Sentinel Lymph Node Status ". JAMA Dermatology 151 (12): 1301. doi:10.1001/jamadermatol.2015.2235. ISSN 2168-6068. 
  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.0 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.8 Katarzyna Lundmark, Britta Krynitz, Ismini Vassilaki, Lena Mölne, Annika Ternesten Bratel. Histopatologisk bedömning och gradering av dysplastiskt nevus samt gränsdragning mot melanom in situ/melanom (Histopathological assessment and grading of dysplastic nevus and distinction from melanoma in situ/melanoma). KVAST (Swedish Society of Pathology). Retrieved on 2019-09-18.
  2. 2.0 2.1 2.2 2.3 Husain, Ehab A; Mein, Charles; Pozo, Lucia; Blanes, Alfredo; Diaz-Cano, Salvador J (2011). "Heterogeneous topographic profiles of kinetic and cell cycle regulator microsatellites in atypical (dysplastic) melanocytic nevi ". Modern Pathology 24 (4): 471–486. doi:10.1038/modpathol.2010.143. ISSN 0893-3952. 

Image sources