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Difference between revisions of "Malignant melanoma"
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==Microscopic== | ==Microscopic== | ||
Features: | ===Non-skin=== | ||
Features (non-skin): | |||
*Classic appearance of melanoma: | *Classic appearance of melanoma: | ||
**Loosely cohesive; mix of small nests of cells, single cells. | **Loosely cohesive; mix of small nests of cells, single cells. | ||
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*May have no nuclear atypia. | *May have no nuclear atypia. | ||
**[[Diagnosis]] is based on architecture (upward spread in the epidermis, single cells, asymmetry). | **[[Diagnosis]] is based on architecture (upward spread in the epidermis, single cells, asymmetry). | ||
===DDx=== | |||
====DDx==== | |||
*Carcinoma. | *Carcinoma. | ||
**Serous carcinoma - both serous carcinoma and melanoma have a large [[nucleolus]]. | **Serous carcinoma - both serous carcinoma and melanoma have a large [[nucleolus]]. | ||
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*Other [[melanocytic lesions]]. | *Other [[melanocytic lesions]]. | ||
===Metastatic | ===Skin=== | ||
Features (skin): | |||
*Architecture: | |||
**Sheeting - diagnostic. | |||
**Asymmetry. | |||
*Lack of maturation. | |||
*+/-Upward scatter of melanocytes - "cannonball" appearance. | |||
Maturation - with depth: | |||
*Nests get smaller. | |||
*Cells get smaller. | |||
*Mitoses decrease. | |||
*Pigmentation decrease. | |||
===Metastatic versus primary=== | |||
Primary lesions should have: | Primary lesions should have: | ||
*Epidermal involvement. | *Epidermal involvement. | ||
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===Breslow thickness=== | ===Breslow thickness=== | ||
*Depth measured from stratum granulosum to deepest intradermal tumour cell - predictive of survival.<ref>{{Ref PCPBoD8|595}}</ref> | *Depth measured from stratum granulosum to deepest intradermal tumour cell - predictive of survival.<ref name=Ref_PCPBoD8>{{Ref PCPBoD8|595}}</ref> | ||
===Subtypes=== | ===Subtypes=== | ||