|
|
(4 intermediate revisions by the same user not shown) |
Line 1: |
Line 1: |
| | [[Image:Blue nevus - intermed mag.jpg|thumb|right|A melanocytic lesion ([[blue nevus]]). [[H&E stain]]. (WC/Nephron)]] |
| '''Melanocytic lesions''' are commonly encountered in [[dermatopathology]] and an area which causes some difficulty, i.e. it is hard to decide in some cases whether a lesion is benign (e.g. [[Spitz nevus]]) or malignant ([[malignant melanoma]]). | | '''Melanocytic lesions''' are commonly encountered in [[dermatopathology]] and an area which causes some difficulty, i.e. it is hard to decide in some cases whether a lesion is benign (e.g. [[Spitz nevus]]) or malignant ([[malignant melanoma]]). |
|
| |
|
Line 110: |
Line 111: |
| =Lentiginous melanocytic lesions= | | =Lentiginous melanocytic lesions= |
| ==Lentigo simplex== | | ==Lentigo simplex== |
| *[[AKA]] ''simple lentigo''.<ref>URL: [http://www.dermnetnz.org/lesions/lentigo-simplex.html http://www.dermnetnz.org/lesions/lentigo-simplex.html]. Accessed on: 27 March 2013.</ref>
| | {{Main|Lentigo simplex}} |
| ===General===
| |
| *Benign.
| |
| *Usually <40 years old.
| |
| | |
| Fits into the larger category of ''lentiginous melanocytic proliferations'' - these include:<ref name=Ref_Derm438>{{Ref Derm|438}}</ref>
| |
| *[[Solar lentigo]].
| |
| *Lentigo simplex.
| |
| *[[Lentiginous nevus]].
| |
| *Lentiginous [[melanoma in situ]].
| |
| | |
| Associated syndromes:<ref name=dermamin_ls>URL: [http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html]. Accessed on: 17 December 2012.</ref>
| |
| *[[Peutz-Jeghers syndrome]].
| |
| *[[LEOPARD syndrome]].
| |
| *[[LAMB syndrome]].
| |
| | |
| ===Gross===
| |
| *Small flat pigmented lesion.<ref name=Ref_WMSP498>{{Ref WMSP|498}}</ref>
| |
| | |
| DDx - clinical:
| |
| *[[Melanocytic nevus]].<ref name=pmid19536147>{{Cite journal | last1 = Hafner | first1 = C. | last2 = Stoehr | first2 = R. | last3 = van Oers | first3 = JM. | last4 = Zwarthoff | first4 = EC. | last5 = Hofstaedter | first5 = F. | last6 = Klein | first6 = C. | last7 = Landthaler | first7 = M. | last8 = Hartmann | first8 = A. | last9 = Vogt | first9 = T. | title = The absence of BRAF, FGFR3, and PIK3CA mutations differentiates lentigo simplex from melanocytic nevus and solar lentigo. | journal = J Invest Dermatol | volume = 129 | issue = 11 | pages = 2730-5 | month = Nov | year = 2009 | doi = 10.1038/jid.2009.146 | PMID = 19536147 }}</ref>
| |
| | |
| ===Microscopic===
| |
| Features:<ref name=Ref_WMSP498>{{Ref WMSP|498}}</ref>
| |
| *Melanocytes in epidermis only.
| |
| **Melanocytes basally located (normal location) with hyperpigmentation.
| |
| *No melanocytic nests.
| |
| *+/-Mild/moderate elongation of the rete ridges.<ref name=pmid19536147/>
| |
| | |
| DDx:<ref name=humpath_ls/>
| |
| *[[Solar lentigo]] - solar elastosis, usu. in sun exposed areas.
| |
| *[[Ephelis]] (freckle) - change with UV light exposure.
| |
| *Melanotic macule.
| |
| *[[Lentiginous nevus]] - has melanocytic nests.
| |
| | |
| ====Images====
| |
| *[http://dermaamin.com/site/histopathology-of-the-skin/64-l/1852-lentigo-simplex-.html Lentigo simplex - several images (dermamin.com)].<ref name=dermamin_ls/>
| |
| *[http://www.humpath.com/IMG/jpg/lentigo_simplex_20x.jpg Lentigo simplex (humpath.com)].<ref name=humpath_ls>URL: [http://www.humpath.com/?lentigo-simplex http://www.humpath.com/?lentigo-simplex]. Accessed on: 17 December 2012.</ref>
| |
| <gallery>
| |
| Image:Skin_Tumors-171.jpg | Simple lentigo. (WC)
| |
| </gallery>
| |
| | |
| ===Sign out===
| |
| <pre>
| |
| SKIN LESION, LEFT ABDOMEN, BIOPSY:
| |
| - SIMPLE LENTIGO, COMPLETELY EXCISED IN THE PLANE OF SECTION.
| |
| </pre>
| |
| | |
| <pre>
| |
| SKIN LESION, LEFT ABDOMEN, BIOPSY:
| |
| - BENIGN SIMPLE LENTIGO.
| |
| </pre>
| |
| | |
| ====Micro====
| |
| The sections show skin with increased numbers of small pigmented melanocytes at the dermal-epidermal junction. The rete ridges are mildly elongated. No solar damage is apparent. No dermal melanocytes are identified. No melanocytic nests are identified. No nuclear atypia is apparent.
| |
|
| |
|
| ==Solar lentigo== | | ==Solar lentigo== |
Line 191: |
Line 138: |
| **Classically at the tips of the rete ridges. | | **Classically at the tips of the rete ridges. |
| *No (melanocyte) nuclear atypia. | | *No (melanocyte) nuclear atypia. |
| *Solar damage ([[solar elastosis]]).<ref name=pmid19536147/> | | *Solar damage ([[solar elastosis]]).<ref name=pmid19536147>{{Cite journal | last1 = Hafner | first1 = C. | last2 = Stoehr | first2 = R. | last3 = van Oers | first3 = JM. | last4 = Zwarthoff | first4 = EC. | last5 = Hofstaedter | first5 = F. | last6 = Klein | first6 = C. | last7 = Landthaler | first7 = M. | last8 = Hartmann | first8 = A. | last9 = Vogt | first9 = T. | title = The absence of BRAF, FGFR3, and PIK3CA mutations differentiates lentigo simplex from melanocytic nevus and solar lentigo. | journal = J Invest Dermatol | volume = 129 | issue = 11 | pages = 2730-5 | month = Nov | year = 2009 | doi = 10.1038/jid.2009.146 | PMID = 19536147 }}</ref> |
|
| |
|
| Notes: | | Notes: |
Line 445: |
Line 392: |
| **Should stain approximally the same number of cells as Melan A. | | **Should stain approximally the same number of cells as Melan A. |
| *Ki-67 -- only rare cells. | | *Ki-67 -- only rare cells. |
| | |
| | ==Nodal nevus== |
| | *AKA ''nevus in lymph node'' and ''benign nevus cells in lymph node''. |
| | {{Main|Nodal nevus}} |
|
| |
|
| =Miscellaneous= | | =Miscellaneous= |