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Difference between revisions of "Compound nevus"
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{{ Infobox diagnosis | |||
| Name = {{PAGENAME}} | |||
| Image = Compound nevus -- intermed mag.jpg | |||
| Width = | |||
| Caption = Compound nevus. [[H&E stain]]. | |||
| Synonyms = compound melanocytic nevus | |||
| Micro = nests of melanocytes in dermis ''and'' epidermis, melanocytes "mature" with depth, usu. no mitoses (occ. superficial), no destruction of surrounding structures, no conspicuous nucleoli, no significant melanocyte enlargement | |||
| Subtypes = | |||
| LMDDx = [[malignant melanoma]] (nevoid), [[junctional nevus]], [[intradermal nevus]], [[dysplastic nevus]] | |||
| Stains = | |||
| IHC = | |||
| EM = | |||
| Molecular = | |||
| IF = | |||
| Gross = pigment skin lesion, usu. small, regular border, no irregularity in pigmentation | |||
| Grossing = | |||
| Site = [[skin]] - see ''[[melanocytic lesions]]'' and ''[[common nevus]]'' | |||
| Assdx = | |||
| Syndromes = | |||
| Clinicalhx = | |||
| Signs = | |||
| Symptoms = | |||
| Prevalence = very common | |||
| Bloodwork = | |||
| Rads = | |||
| Endoscopy = | |||
| Prognosis = benign | |||
| Other = | |||
| ClinDDx = pigmented skin lesions | |||
| Tx = none required, may be excised for cosmetic reasons | |||
}} | |||
'''Compound nevus''' (abbreviated '''CN'''), also '''compound melanocytic nevus''' (abbreviated '''CMN'''), is a common benign [[melanocytic lesion]]. | '''Compound nevus''' (abbreviated '''CN'''), also '''compound melanocytic nevus''' (abbreviated '''CMN'''), is a common benign [[melanocytic lesion]]. | ||
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*Benign. | *Benign. | ||
*Common. | *Common. | ||
* | *Arise from [[junctional nevus|junctional nevi]] and then progress to [[intradermal nevi]].<ref>URL: [http://www.dermpedia.org/dermpedia-textbook/compound-nevus http://www.dermpedia.org/dermpedia-textbook/compound-nevus]. Accessed on: 20 May 2014.</ref> | ||
Clinical: | Clinical - think about [[malignant melanoma]]... it should ''not'' be like melanoma: | ||
*''ABCD'' = asymmetric, borders (irregular), colour (black), diameter (large). | *''ABCD'' = asymmetric, borders (irregular), colour (black), diameter (large). | ||
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Features: | Features: | ||
*Symmetrical lesion. | *Symmetrical lesion. | ||
*"Matures" with depth | *"Matures" with depth. | ||
**Less cellular with depth | **Less cellular with depth. | ||
**Less nuclear atypia with depth. | **Less nuclear atypia with depth. | ||
**Smaller cells with depth. | **Smaller cells with depth. | ||
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*In the dermis '''and''' epidermis - '''key feature'''. | *In the dermis '''and''' epidermis - '''key feature'''. | ||
*+/-Adipocytes - uncommon.<ref name=pmid9810886>{{Cite journal | last1 = Eng | first1 = W. | last2 = Cohen | first2 = PR. | title = Nevus with fat: clinical characteristics of 100 nevi containing mature adipose cells. | journal = J Am Acad Dermatol | volume = 39 | issue = 5 Pt 1 | pages = 704-11 | month = Nov | year = 1998 | doi = | PMID = 9810886 }}</ref> | *+/-Adipocytes - uncommon.<ref name=pmid9810886>{{Cite journal | last1 = Eng | first1 = W. | last2 = Cohen | first2 = PR. | title = Nevus with fat: clinical characteristics of 100 nevi containing mature adipose cells. | journal = J Am Acad Dermatol | volume = 39 | issue = 5 Pt 1 | pages = 704-11 | month = Nov | year = 1998 | doi = | PMID = 9810886 }}</ref> | ||
DDx: | |||
*[[Malignant melanoma]] (nevoid). | |||
*[[Dysplastic nevus]]. | |||
*[[Junctional nevus]]. | |||
*[[Intradermal nevus]]. | |||
===Images=== | ===Images=== | ||
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===Micro=== | ===Micro=== | ||
The sections show melanocytes in the dermis and epidermis. The lesion is symmetrical in its architecture and pigment distribution. There is no pagetoid spread of melanocytes in the epidermis. Superficially, melanocytes are in nests. Melanocytes show no apparent cytologic atypia and mature with depth. No mitotic activity is appreciated. | The sections show melanocytes in the dermis and epidermis. The lesion is symmetrical in its architecture and pigment distribution. There is no pagetoid spread of melanocytes in the epidermis. Superficially, melanocytes are in nests. Melanocytes show no apparent cytologic atypia and mature with depth. No mitotic activity is appreciated. The lesion is completely excised in the plane of section. | ||
The lesion is completely excised in the plane of section. | |||
====Barely compound==== | ====Barely compound==== | ||
The sections show melanocytes predominantly in the dermis. Rare melanocytic nests are seen at the dermal-epidermal junction. There is no pagetoid spread of melanocytes in the epidermis. The lesion is symmetrical in its architecture. Superficially, melanocytes are in nests and pigment is present. The melanocytes mature with depth. No mitotic activity is appreciated. | The sections show melanocytes predominantly in the dermis. Rare melanocytic nests are seen at the dermal-epidermal junction. There is no pagetoid spread of melanocytes in the epidermis. The lesion is symmetrical in its architecture. Superficially, melanocytes are in nests and pigment is present. The melanocytes mature with depth. No mitotic activity is appreciated. The lesion is present at the margin. | ||
The lesion is | ====Congenital features present==== | ||
The sections show melanocytes in the dermis and epidermis. There is no pagetoid spread of melanocytes in the epidermis. Superficially, melanocytes are in nests. Melanocytes show mild nuclear enlargement but mature with depth. Nucleoli are not prominent. Melanocytes are found adjacent to adnexal structures and blood vessels. No mitotic activity is appreciated. The lesion is incompletely excised. | |||
==See also== | ==See also== | ||