Difference between revisions of "Template:Epidermal and junctional nevus grading"
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− | {{Edit-int|Template:Epidermal and junctional nevus grading}} | + | {{Edit-int|Template:Epidermal and junctional nevus grading}}<br>It is acceptable to grade a dysplastic nevus into either low or high grade by the following algorithm:<ref>{{cite journal|last1=Pozo|first1=Lucia|last2=Naase|first2=Mahmoud|last3=Cerio|first3=Rino|last4=Blanes|first4=Alfredo|last5=Diaz-Cano|first5=Salvador J.|title=Critical Analysis of Histologic Criteria for Grading Atypical (Dysplastic) Melanocytic Nevi|journal=American Journal of Clinical Pathology|volume=115|issue=2|year=2001|pages=194–204|issn=0002-9173|doi=10.1309/KXJW-1UJE-BPG6-AXBV}}</ref><ref group="notes" name="regression"/> |
[[File:Algorithm for low grade versus high grade dysplastic nevus.png|center|250px]] | [[File:Algorithm for low grade versus high grade dysplastic nevus.png|center|250px]] | ||
Revision as of 09:35, 16 March 2020
Template:Edit-int
It is acceptable to grade a dysplastic nevus into either low or high grade by the following algorithm:[1][notes 1]
In uncertain cases, more specific grading, and/or differentiation from a non-atypical congenital nevus and suspected melanoma, the following table can be used to determine the most fitting diagnosis:
Parameter | Non-atypical congenital pattern | Low-grade dysplastic nevus | High-grade dysplastic nevus | Suspected melanoma in situ | ||
---|---|---|---|---|---|---|
Mild dysplasia | Moderate dysplasia | Severe dysplasia | ||||
Macroscopic | Lateral circumscription[2] | Sharp | Slightly diminished | Moderate | Poor | |
Symmetry[2] | Good | Often broken | Rare | |||
Structural (Low mag.) |
Delimitation[3] | Rarely diffuse | Sometimes diffuse | Often diffuse | ||
Lentiginous proliferation[note 1][3] | 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[3] | Rarely | Often | ||||
Confluent nests[3] | Rarely | Sometimes | Often | Often widespread | ||
Pigment distribution[3] | Regular | Irregular | ||||
Suprabasal presence (less than most superficial third of subcorneal epidermis) | Occasionally centrally[2] | No[3] or rarely[2] | Occasionally centrally[2] | Yes, multifocal[3] | ||
Pagetoid migration including superficial third of subcorneal epidermis[3] | No | No | Yes, in a maximum of 2 HPF centrally, but not peripherally | Yes, multifocal and/or in periphery | ||
Extended rete pegs | Ocassional[2] | Yes, regular[3] | Yes, varying[3] | Yes, often irregular[3] | Varying, flattened[3] | |
Concentric fibrosis | Regressive[2] | Yes[3] | Occasional[2] | |||
Lamellar fibrosis | Rarely[3] | Often[3] | Often pronounced[3] | Occasional[2] | ||
Lymphocytic infiltrate[3] | Mild, perivascular | Mild or moderate, perivascular | Varying | Varying | ||
Suprapapillary plate involvement | No[2] | Usually no[2] | Often[2] | Yes[2] | ||
Cellular (high mag.) |
Image | |||||
Junctional extension[2] | Unusual | Usual | Extensive | |||
Nuclear size[2] | Age-related | Small | Medium | Large | Medium or large. Pleomorphic[4] | |
Nuclear pleomorphism[5] | Slight | Prominent | ||||
Chromatin pattern | Uniform[2] | Condensed[2] | Partically expanded[2] | Expanded, coarse in some cells[2] | Expanded, hyperchromatic, coarse.[2] Usually granular.[5] | |
Nucleoli[2] | Age-related | Small | Medium | Large | Usually[5] large | |
Mitoses[2] | Few superficial | Superficial and deep | ||||
Histological regression[5][note 2] | Usually | Usually not | ||||
Percentage of atypical melanocytes[3] | <10% | About 10 - 50% | about 50-90% | Usually> 90% | ||
Intradermal melanocytic atypia[3] | No | Rarely, in superficial part | Can be detected in superficial part | |||
Intradermal melanocyte maturation[3] | Yes | Yes, can be partial | Yes, can be partial | Variable |
In suspected but not certain nevus or melanoma in situ, generally perform immunohistochemistry with SOX10, whereby melanocyte proliferation and nuclear pleomorphism is easier to see.[note 3]
- ↑ Pozo, Lucia; Naase, Mahmoud; Cerio, Rino; Blanes, Alfredo; Diaz-Cano, Salvador J. (2001). "Critical Analysis of Histologic Criteria for Grading Atypical (Dysplastic) Melanocytic Nevi ". American Journal of Clinical Pathology 115 (2): 194–204. doi: . ISSN 0002-9173.
- ↑ 2.00 2.01 2.02 2.03 2.04 2.05 2.06 2.07 2.08 2.09 2.10 2.11 2.12 2.13 2.14 2.15 2.16 2.17 2.18 2.19 2.20 2.21 Arumi-Uria, Montserrat; McNutt, N Scott; Finnerty, Bridget (2003). "Grading of Atypia in Nevi: Correlation with Melanoma Risk ". Modern Pathology 16 (8): 764–771. doi: . ISSN 0893-3952.
- ↑ 3.00 3.01 3.02 3.03 3.04 3.05 3.06 3.07 3.08 3.09 3.10 3.11 3.12 3.13 3.14 3.15 3.16 3.17 3.18 3.19 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.
- ↑ Christopher S. Hale. Skin melanocytic tumor - Melanoma - Invasive melanoma. Topic Completed: 1 May 2013. Revised: 17 September 2019
- ↑ 5.0 5.1 5.2 5.3 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: . ISSN 0893-3952.
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