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 © 2001-2009, DermAtlas | Image Name: | vulva_nevus_2_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, GENITAL / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | vulva (labia) | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The melanocytic nests are large and expansile. They are located at all positions along the retia. There is the appearance of loss of cellular cohesion within the nests. Individual melanocytes are enlarged. Mitotic activity is not appreciated. | ||||
| Comments: | This 10 year old female presented with a pigmented papule on her vulva. A subset of genital nevi look unremarkable clinically but have atypical histologic features. This is well-described in the literature. Genital nevi include those on the labia, mons, perineum, penis and scrotum. The histologic features may mimic nodular melanoma. Often times, these nevi have large expansile nests, located at all positions along the retia. There is typically loss of cellular cohesion. There may be cytologic atypia, both epidermally and dermally. Rare mitoses may even be observed. Because it is rare for premenapausal women to develop vulvar melanoma, these features should be heavily scrutinized and the lesion excised if in doubt [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | vulva_nevus_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | vulva_nevus_1_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, GENITAL / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | vulva (labia) | Age: | 10 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | At low power, the epidermis is acanthotic and papillomatous. Thre is a cellular nevomelanocytic lesion, involving the epidermis and dermis. There is overall symmetry. | ||||
| Comments: | This 10 year old female presented with a pigmented papule on her vulva. A subset of genital nevi look unremarkable clinically but have atypical histologic features. This is well-described in the literature. Genital nevi include those on the labia, mons, perineum, penis and scrotum. The histologic features may mimic nodular melanoma. Often times, these nevi have large expansile nests, located at all positions along the retia. There is typically loss of cellular cohesion. There may be cytologic atypia, both epidermally and dermally. Rare mitoses may even be observed. Because it is rare for premenapausal women to develop vulvar melanoma, these features should be heavily scrutinized and the lesion excised if in doubt [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | vulva_nevus_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | acral_nevus_1_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, ACRAL / NEVUS, PIGMENTED / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | toe | Age: | 33 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | Histologic sections are of acral skin. There is a fairly symmetric cellular lesion involving the epidermis and dermis. | ||||
| Comments: | This 33 year old woman presented with a pigmented papule on her 3rd toe. It was biopsied to rule out melanoma. Acral nevi are a subset of melanocytic nevocellular nevi, which can have atypical clinical and histologic findings, but are benign. Clinically, the lesions often have irregular but sharp borders, likely due to the presence of dermatoglyphs. Histologically, they may also have atypical features. The most notorious and often striking feature is upward migration of melanocytes. This can mimic the pagetoid growth of melanoma in situ. Other features include overall symmetry, maturation with syringotropism, and lack of mitotic activity or significant cytologic atypia [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | All related Images acral_nevus_3_090401 acral_nevus_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | acral_nevus_2_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, ACRAL / NEVUS, PIGMENTED / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | toe | Age: | 33 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There are large expansile nevocellular nests. There is syringotropsim of the melanocytes. Significant cytologic atpyia is not appreciated. | ||||
| Comments: | This 33 year old woman presented with a pigmented papule on her 3rd toe. It was biopsied to rule out melanoma. Acral nevi are a subset of melanocytic nevocellular nevi, which can have atypical clinical and histologic findings, but are benign. Clinically, the lesions often have irregular but sharp borders, likely due to the presence of dermatoglyphs. Histologically, they may also have atypical features. The most notorious and often striking feature is upward migration of melanocytes. This can mimic the pagetoid growth of melanoma in situ. Other features include overall symmetry, maturation with syringotropism, and lack of mitotic activity or significant cytologic atypia [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | All related Images acral_nevus_3_090401 acral_nevus_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | acral_nevus_3_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, ACRAL / NEVUS, PIGMENTED / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | toe | Age: | 33 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The melanocytes proliferate along the junction, with foci of lentiginous growth. There are large nests, positioned along the retia. In one focus, single cells and few aggregates ascend into the epidermis. These are not cytologically atypical. | ||||
| Comments: | This 33 year old woman presented with a pigmented papule on her 3rd toe. It was biopsied to rule out melanoma. Acral nevi are a subset of melanocytic nevocellular nevi, which can have atypical clinical and histologic findings, but are benign. Clinically, the lesions often have irregular but sharp borders, likely due to the presence of dermatoglyphs. Histologically, they may also have atypical features. The most notorious and often striking feature is upward migration of melanocytes. This can mimic the pagetoid growth of melanoma in situ. Other features include overall symmetry, maturation with syringotropism, and lack of mitotic activity or significant cytologic atypia [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | All related Images acral_nevus_2_090401 acral_nevus_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | breast_nevus_1_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, SPECIAL SITE / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | breast | Age: | 35 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a cellular pigmented lesion, with epidermal and dermal components. The melanocytic nests are irregularly shaped and fuse retia, with a garland pattern. Significant upward migration is not appreciated. | ||||
| Comments: | This 35 year old woman presented with a pigmented papule on her breast. Recent publications have identified a subset of breast nevi which are clinically unremarkable but have atypical histologic features, similar to those described at other anatomic sites (genital). Along with scalp, ear, and a growing list of others, these have been designated nevi of special sites. These are benign. The atypical features include lentiginous growth and cytologic atypica, to name a few, and these overlap histologically with nevi with architectural disorder. These have not been shown, to date, to be premalignant or be markers for malignancy, but are mere histologic observations not to be overdiagnosed as melanoma [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | breast_nevus_2_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | breast_nevus_2_090401 | File Type: | jpg | |
| Diagnosis: | NEVUS, SPECIAL SITE / NEVUS, PIGMENTED, ATYPICAL | Category: | neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | breast | Age: | 35 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | The melanocytes are enlarged. They are present both singly and in nests, with lentiginous growth. Upward migration is not appreciated. The dermal component appears to mature. | ||||
| Comments: | This 35 year old woman presented with a pigmented papule on her breast. Recent publications have identified a subset of breast nevi which are clinically unremarkable but have atypical histologic features, similar to those described at other anatomic sites (genital). Along with scalp, ear, and a growing list of others, these have been designated nevi of special sites. These are benign. The atypical features include lentiginous growth and cytologic atypica, to name a few, and these overlap histologically with nevi with architectural disorder. These have not been shown, to date, to be premalignant or be markers for malignancy, but are mere histologic observations not to be overdiagnosed as melanoma [J Cutan Pathol 2008;35:889-898]. | ||||
| Related Images: | breast_nevus_1_090401 | ||||
 © 2001-2009, DermAtlas | Image Name: | Hairy_Nevus_V1_disttrbution_1_090304 | File Type: | jpg | |
| Diagnosis: | NEVUS, PIGMENTED, CONGENITAL / NEVUS, PIGMENTED / MALFORMATION, CONGENITAL | Category: | neoplasm, melanocytic / lumps & bumps (plaques, nodules, tumors) / congenital malformation | ||
| Body Site: | forehead / eye lid canthus, outer / face eye brow / canthus, inner | Age: | 2 years | ||
| Contributor: | Jeffrey Newman, MD, PhD | ||||
| Description: | well demarcated dark brown 7 X 5 cm leathery plaque with overlying coarse dark hair | ||||
| Comments: | This 2-year-old girl was noted to have a medium size congenital pigmented nevus with coarse dark hair on the left side of the forehead at birth. | ||||
 © 2001-2009, DermAtlas | Image Name: | macromelanosomes_1_071101 | File Type: | jpg | |
| Diagnosis: | CAFé AU LAIT SPOT / MACROMELANOSOMES | Category: | histologic finding / neoplasm, melanocytic / neoplasm, benign | ||
| Body Site: | thigh | Age: | 32 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a nevomelanocytic lesion, confined to the epidermis. There are nevomelanocytes present both singly and in nests along the dermoepidermal junction. Varibly-sized melanosomes, some macro forms, are evident in the junctional melanocytes, There is no cytologic atypia. | ||||
| Comments: | This café au lait spot shows typical histology. Macromelanosomes were thought to be specific for this entity but is not as pathognomonic as originally believed. There is likely some abnormality in melanin or melanosome production, leading to the size variability. | ||||
 © 2001-2009, DermAtlas | Image Name: | melanoma_mucinous_1_070501 | File Type: | jpg | |
| Diagnosis: | MELANOMA, METASTATIC | Category: | neoplasm, melanocytic / neoplasm, metastatic | ||
| Body Site: | back | Age: | 56 years | ||
| Contributor: | Greg Hosler, MD, PhD | ||||
| Description: | There is a large, well-demarcated tumor within the deep dermis. The cells are small and basaloid, with a mucinous stroma. | ||||
| Comments: | This is an unusual morphologic variant of melanoma. It has both small-cell and mucinous features, showing how melanoma can truly take on any appearance. This morphology is usually associated with elderly patients. This patient is a little young. She had an acral melanoma two years prior. This was a metastasis to the back and only loosely resembled the invasive component of the original. It was S-100 and MART-1 positive (not shown). | ||||
| Related Images: | melanoma_mucinous_2_070501 | ||||
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