Atypical lentiginous nevus

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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

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.[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.

External links