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Difference between revisions of "Malignant melanoma"
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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>{{Ref PCPBoD8|595}}</ref> | ||
===Subtypes=== | |||
===Benign lesions=== | |||
{| class="wikitable sortable" style="margin-left:auto;margin-right:auto" | |||
| '''Subtype name''' | |||
| '''Key feature''' | |||
| '''Microscopic additional''' | |||
| '''DDx''' | |||
| '''Image''' | |||
| '''Notes/other''' | |||
|- | |||
| Melanoma in situ | |||
| confined to epidermis, nuclear atypia | |||
| melanocyte enlargement, nuclear hyperchromasia, +/- melanocytes above suprapapillary plate (above basal layer) = "Pagetoid spread" | |||
| melanocytic hyperplasia, pagetoid Spitz nevus | |||
| Image? | |||
| Notes/other? | |||
|- | |||
| Malignant melanoma - superficial spreading type | |||
| atypical melanocytes at all levels of epidermis + dermis | |||
| atypical dermal melanocytes single, in cluster or sheets | |||
| compound melanocytic nevus | |||
| Image? | |||
| Notes/other? | |||
|- | |||
| Malignant melanoma - lentiginous type | |||
| atypical melanocytes prominent along basal keratinocytes + in dermis | |||
| nuclear atypia | |||
| DDx? | |||
| Image? | |||
| Notes/other? | |||
|- | |||
| Malignant melanoma - nodular type | |||
| dermal large nodule/sheet | |||
| nuclear atypia; may not be prominent in epidermis | |||
| metastatic melanoma | |||
| Image? | |||
| Notes/other? | |||
|- | |||
| Malignant melanoma - desmoplastic-neurotropic type | |||
| large atypical spindle cells, btw collagen | |||
| predominantly dermal | |||
| [[pleomorphic undifferentiated sarcoma]] (MFH), [[scar]], [[dermatofibroma]], [[DFSP]], [[leiomyosarcoma]] | |||
| Image? | |||
| Notes/other? | |||
|- | |||
| Malignant melanoma - nevoid type | |||
| prominent nucleoli, deep mitoses - high power diagnosis | |||
| mimics nevus at low power | |||
| (benign) nevus | |||
| Image? | |||
| Notes/other? | |||
|- | |||
| Malignant melanoma - spitzoid type | |||
| nested pattern, nuclear atypia, no maturation (large deep cells) | |||
| NC ratio increased (vs. Spitz) | |||
| [[Spitz nevus]] | |||
| Image? | |||
| Notes/other? | |||
|} | |||
==[[Electron microscopy]]== | ==[[Electron microscopy]]== | ||