This biopsy of a nevus on the right foot of a 65-year-old woman revealed a compound nevus with architectural disorder and focally severe cytologic atypia. These features may be seen in nevi from individuals with the familial atypical mole-melanoma syndrome.
There is intraepidermal lentiginous hyperplasia of melanocytes, random cytological atypia, a stromal response, and architectural atypia. Lentiginous hyperplasia means that melanocytes are proliferating in nests along the basal layer, as well as singly. An intradermal component of nevus cells are seen. Cells in the upper dermis are cuboidal and contain more melanin pigment in the cytoplasm than smaller, deeper cells. Focal scarring of the superficial dermis is also common.