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

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]

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

  1. Edwards, SL.; Blessing, K. (Jun 2000). "Problematic pigmented lesions: approach to diagnosis.". J Clin Pathol 53 (6): 409-18. PMID 10911797.
  2. Kossard, S. (May 2002). "Atypical lentiginous junctional naevi of the elderly and melanoma.". Australas J Dermatol 43 (2): 93-101. PMID 11982564.
  3. 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. 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.