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Atypical lentiginous nevus (view source)
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'''Atypical lentiginous nevus''', also '''atypical lentiginous nevus of the elderly''', is a [[melanocytic lesion]] associated with old age and melanoma. | {{ Infobox diagnosis | ||
| Name = {{PAGENAME}} | |||
| Image = | |||
| Width = | |||
| Caption = | |||
| Micro = elongated rete ridges (key feature), diffuse (non-lamellar) superficial dermal fibrosis, mild-to-moderated cytologic atypia | |||
| Subtypes = | |||
| LMDDx = [[dysplastic nevus]], [[melanoma in situ]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = | |||
| Grossing = | |||
| Site = [[skin]] | |||
| Assdx = [[malignant melanoma]] | |||
| Syndromes = | |||
| Clinicalhx = elderly population | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = | |||
| Other = | |||
| ClinDDx = [[melanoma]] | |||
}} | |||
'''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'''. | |||
It can be considered a type of [[dysplastic nevus]].<ref name=pmid10911797>{{Cite journal | last1 = Edwards | first1 = SL. | last2 = Blessing | first2 = K. | title = Problematic pigmented lesions: approach to diagnosis. | journal = J Clin Pathol | volume = 53 | issue = 6 | pages = 409-18 | month = Jun | year = 2000 | doi = | PMID = 10911797 }}</ref><ref>{{Cite journal | last1 = Kossard | first1 = S. | title = Atypical lentiginous junctional naevi of the elderly and melanoma. | journal = Australas J Dermatol | volume = 43 | issue = 2 | pages = 93-101 | month = May | year = 2002 | doi = | PMID = 11982564 }}</ref> | It can be considered a type of [[dysplastic nevus]].<ref name=pmid10911797>{{Cite journal | last1 = Edwards | first1 = SL. | last2 = Blessing | first2 = K. | title = Problematic pigmented lesions: approach to diagnosis. | journal = J Clin Pathol | volume = 53 | issue = 6 | pages = 409-18 | month = Jun | year = 2000 | doi = | PMID = 10911797 }}</ref><ref>{{Cite journal | last1 = Kossard | first1 = S. | title = Atypical lentiginous junctional naevi of the elderly and melanoma. | journal = Australas J Dermatol | volume = 43 | issue = 2 | pages = 93-101 | month = May | year = 2002 | doi = | PMID = 11982564 }}</ref> | ||
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==Microscopic== | ==Microscopic== | ||
Features:<ref name=pmid22421501>{{Cite journal | last1 = Agustí-Mejias | first1 = A. | last2 = Messeguer Badia | first2 = F. | last3 = García Ruiz | first3 = R. | last4 = Oliver Martínez | first4 = V. | last5 = Alegre de Miquel | first5 = V. | title = [Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases]. | journal = Actas Dermosifiliogr | volume = 103 | issue = 5 | pages = 394-400 | month = Jun | year = 2012 | doi = 10.1016/j.ad.2011.10.006 | PMID = 22421501 }}</ref> | Features:<ref name=pmid22421501>{{Cite journal | last1 = Agustí-Mejias | first1 = A. | last2 = Messeguer Badia | first2 = F. | last3 = García Ruiz | first3 = R. | last4 = Oliver Martínez | first4 = V. | last5 = Alegre de Miquel | first5 = V. | title = [Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases]. | journal = Actas Dermosifiliogr | volume = 103 | issue = 5 | pages = 394-400 | month = Jun | year = 2012 | doi = 10.1016/j.ad.2011.10.006 | PMID = 22421501 | URL = http://www.actasdermo.org/en/atypical-lentiginous-nevus-a-clinical/articulo/90149637/?pubmed=true }}</ref> | ||
*Elongated rete ridges - '''key feature'''. | *Elongated rete ridges - '''key feature'''. | ||
*Superficial dermal fibrosis, diffuse (non-lamellar) - '''important'''. | *Superficial dermal fibrosis, diffuse (non-lamellar) - '''important'''. | ||
*Mild-to- | *Mild-to-moderate cytologic atypia, focal. | ||
Notes:<ref name=pmid22421501/> | |||
*Rarely dermal nests. | |||
*Mild-to-moderate inflammation. | |||
*Mitoses - never. | |||
*[[Solar elastosis]] - mild-to-moderate. | |||
DDx:<ref name=pmid22421501/> | DDx:<ref name=pmid22421501/> | ||
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*[[Dysplastic nevus]] - lamellar fibrosis. | *[[Dysplastic nevus]] - lamellar fibrosis. | ||
*[[Lentigo simplex]]. | *[[Lentigo simplex]]. | ||
*[[Lentigo maligna]]. | *[[Lentigo maligna]] - more atypia, upward migration of melanocytes, occasional mitoses. | ||
*[[Solar lentigo]]. | *[[Solar lentigo]] - [[solar elastosis]]. | ||
*[[Lentiginous nevus]]. | *[[Lentiginous nevus]]. | ||
===Images=== | |||
*[http://www.actasdermo.org/imatges/403/403v103n05/grande/403v103n05-90149637fig2.jpg ALN (actasdermo.org)].<ref name=pmid22421501/> | |||
==Sign out== | |||
<pre> | |||
SKIN LESION, CENTRAL BACK, SHAVE EXCISION: | |||
- ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. | |||
-- COMPLETELY EXCISED, (CLEARANCE 2 MM). | |||
</pre> | |||
<pre> | |||
SKIN LESION, CENTRAL BACK, SHAVE EXCISION: | |||
- ATYPICAL LENTIGINOUS NEVUS. | |||
-- COMPLETELY EXCISED, (CLEARANCE 2 MM). | |||
-- MILD CYTOLOGIC ATYPIA. | |||
</pre> | |||
===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== | ==See also== | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
==External links== | |||
*[http://www.dermpedia.org/dermpedia-textbook/compound-nevus-with-atypia Compound nevus with atypia (dermpedia.org)]. | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Dermatopathology]] | [[Category:Dermatopathology]] | ||