48,466
edits
Difference between revisions of "Talk:Melanocytic lesions"
Jump to navigation
Jump to search
→Spongiotic changes: new section
(→Compound nevus, congenital type - 2: new section) |
(→Spongiotic changes: new section) |
||
| (7 intermediate revisions by the same user not shown) | |||
| Line 8: | Line 8: | ||
== Compound nevus, congenital type - 2 == | == Compound nevus, congenital type - 2 == | ||
The sections show a hair bearing skin with a melanocytic lesion involving both the deep epidermis and dermis. Melanocytes through-out the sections are small, lack nuclear atypia and nucleoli. Mitoses are not identified. In the, epidermis the melanocytes are basal and focally pigmented. In the | The sections show a hair bearing skin with a melanocytic lesion involving both the deep epidermis and dermis. Melanocytes through-out the sections are small, lack nuclear atypia and nucleoli. Mitoses are not identified. In the, epidermis the melanocytes are basal and focally pigmented. In the superficial dermis the melanocytes are in nests and focally pigmented. In the deep dermis the melanocytes are smaller than in the superficial dermis, lack pigmentation and spindled. The lesion shows congenital features; melanocytes cluster around adenxal structures and blood vessels. The lesion is present at the margin. | ||
Thick collagen bundles replace adenxal structures in the dermis focally and is associated with loss of rete ridges in the overlying epidermis; this is consistent with a prior excision at the site. | Thick collagen bundles replace adenxal structures in the dermis focally and is associated with loss of rete ridges in the overlying epidermis; this is consistent with a prior excision at the site. | ||
| Line 14: | Line 14: | ||
There is no evidence of malignancy and no significant inflammation. | There is no evidence of malignancy and no significant inflammation. | ||
===Final=== | ===Final=== | ||
A. Cheek lesion ("nevus"), right, serial excision - Compound congenital-type nevus | A. Cheek lesion ("nevus"), right, serial excision - Compound congenital-type nevus; lesional tissue extend to the multiple side margins but not the deep margins | ||
== Blue nevus == | |||
===Microscopic description=== | |||
The sections show a dermal lesion consisting of heavily pigmented epithelioid and spindle cells interspersed between collagen bundles. There is no nuclear atypia and the lesion does not extend into the superficial dermis. Lesional cells decrease in size and become more spindled with increasing depth. No mitotic activity is identified. | |||
===Final diagnosis=== | |||
Skin, posterior thorax, biopsy:<br> | |||
Blue nevus, see comment. | |||
Comment: Nevus cells are seen focally at the edges of the section; clinical correlation for excision status is required. | |||
== Intradermal nevus == | |||
===Microscopic=== | |||
The sections show skin with small, nested, epithelioid intradermal melanocytes without nuclear atypia that become spindled with depth. No mitotic activity is identified. No intraepidermal component is identified. | |||
===Final diagnosis=== | |||
Skin, right thigh ("mole"), excision: <br> | |||
- POLYPOID INTRADERMAL NEVUS. | |||
== Dysplastic nevus versus lentiginous nevus of the elderly == | |||
<pre> | |||
SKIN LESION, LEFT LOWER BACK, SHAVE BIOPSY: | |||
- SUPERFICIAL COMPOUND NEVUS WITH MODERATE CYTOLOGIC ATYPIA AND MODERATE | |||
ARCHITECTURAL DISORDER, MARGINALLY EXCISED, SEE COMMENT. | |||
COMMENT: | |||
The nevus shows lentiginous features not otherwise classified with overlap between | |||
dysplastic nevus and lentiginous nevus of the elderly. Suggest a conservative re-excision. | |||
</pre> | |||
== Spongiotic changes == | |||
<pre> | |||
SKIN LESION, BACK, BIOPSY: | |||
- SUPERFICIAL LENTIGINOUS COMPOUND NEVUS WITH DERMATITIC CHANGES AND CHANGES | |||
SUGGESTIVE OF REMOTE EPIDERMAL NECROSIS, EXCISED IN PLANE OF SECTION. | |||
</pre> | |||
===Micro=== | |||
The sections show skin with pigmented junctional melanocytes, acanthosis, pigmented | |||
hyperkeratosis, and hypergranulosis. Rare dermal melanocytes are seen. There is no | |||
significant nuclear atypia. No mitotic activity is apparent. The lesion is clear of the | |||
margins in the planes of section. | |||