Atypical lentiginous nevus
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Atypical lentiginous nevus, also atypical lentiginous nevus of the elderly, is a melanocytic lesion associated with old age and melanoma. It may be abbreviated ALN.
| Atypical lentiginous nevus | |
|---|---|
| Diagnosis in short | |
|
| |
| LM | elongated rete ridges (key feature), diffuse (non-lamellar) superficial dermal fibrosis, mild-to-moderated cytologic atypia |
| LM DDx | dysplastic nevus, melanoma in situ |
| Site | skin |
|
| |
| Associated Dx | malignant melanoma |
| Clinical history | elderly population |
| Clin. DDx | melanoma |
It can be considered a type of dysplastic nevus.[1][2]
General
- Associated with malignant melanoma.[3]
Gross
- Pigmented lesion.
- Size: 0.3-1.0 cm.[4]
Microscopic
Features:[4]
- Elongated rete ridges - key feature.
- Superficial dermal fibrosis, diffuse (non-lamellar) - important.
- Mild-to-moderate cytologic atypia, focal.
Notes:[4]
- Rarely dermal nests.
- Mild-to-moderate inflammation.
- Mitoses - never.
- Solar elastosis - mild-to-moderate.
DDx:[4]
- Lentiginous melanoma.
- Dysplastic nevus - lamellar fibrosis.
- Lentigo simplex.
- Lentigo maligna - more atypia, upward migration of melanocytes, occasional mitoses.
- Solar lentigo - solar elastosis.
- Lentiginous nevus.
Images
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SKIN LESION, CENTRAL BACK, SHAVE EXCISION: - ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. -- COMPLETELY EXCISED, (CLEARANCE 2 MM).
SKIN LESION, CENTRAL BACK, SHAVE EXCISION: - ATYPICAL LENTIGINOUS NEVUS. -- COMPLETELY EXCISED, (CLEARANCE 2 MM). -- MILD CYTOLOGIC ATYPIA.
Micro
The sections show hair-bearing skin with elongated rete ridges with focal bridging, and lentiginous, mildly atypical melanocytes. Non-lamellar superficial dermal fibrosis is present. No upward scatter of melanocytes is apparent.
The lesion is completely excised in the plane of section.
See also
References
- ↑ Edwards, SL.; Blessing, K. (Jun 2000). "Problematic pigmented lesions: approach to diagnosis.". J Clin Pathol 53 (6): 409-18. PMID 10911797.
- ↑ Kossard, S. (May 2002). "Atypical lentiginous junctional naevi of the elderly and melanoma.". Australas J Dermatol 43 (2): 93-101. PMID 11982564.
- ↑ Kossard, S.; Commens, C.; Symons, M.; Doyle, J. (1991). "Lentinginous dysplastic naevi in the elderly: a potential precursor for malignant melanoma.". Australas J Dermatol 32 (1): 27-37. PMID 1930003.
- ↑ 4.0 4.1 4.2 4.3 4.4 Agustí-Mejias, A.; Messeguer Badia, F.; García Ruiz, R.; Oliver Martínez, V.; Alegre de Miquel, V. (Jun 2012). "[Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases].". Actas Dermosifiliogr 103 (5): 394-400. doi:10.1016/j.ad.2011.10.006. PMID 22421501.