Differential diagnosis of heavily pigmented melanocytic lesions: Challenges and diagnostic approach

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

The differential diagnosis of heavily pigmented melanocytic neoplasms includes melanoma (especially animal type), melanosis of partially or completely regressed melanoma, blue naevus (BN), pigmented Spitzoid lesions, recurrent naevus, combined naevus, pigmented spindle cell naevus, epithelioid blue naevus of the Carney complex/pigmented epithelioid melanocytoma, deep penetrating naevus, hyperpigmented scar after surgery of melanoma in which there are also melanophages and hyperpigmentation due to the minocycline, a tattoo or a hyperpigmented scar. Pathologists face challenges when evaluating a pigmented lesion, especially in a small superficial biopsy, because it is difficult to access important histopathological features to differentiate benign versus malignant melanocytic lesions. The histological features that favour a diagnosis of melanoma include dimension (>6 mm), asymmetry, poor circumscription, irregular confluent nests, confluent lentiginous junctional melanocytic proliferation, lack of maturation with descent in the dermis, suprabasal pagetoid melanocytes, asymmetrical distribution of melanin pigment, cytological atypia, dermal mitotic figures, asymmetrical dermal lymphocytic infiltrate and necrosis.

Original languageEnglish (US)
Pages (from-to)963-970
Number of pages8
JournalJournal of Clinical Pathology
Volume68
Issue number12
DOIs
StatePublished - Dec 1 2015

Fingerprint

Melanoma
Differential Diagnosis
Blue Nevus
Nevus
Spindle Cell Nevus
Cicatrix
Carney Complex
Melanosis
Pigmented Nevus
Skin
Hyperpigmentation
Minocycline
Melanocytes
Melanins
Dermis
Necrosis
Biopsy
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Differential diagnosis of heavily pigmented melanocytic lesions : Challenges and diagnostic approach. / Aung, Phyu P; Maloney, Kudakwashe; Danialan, Richard; Ivan, Doina; Prieto, Victor.

In: Journal of Clinical Pathology, Vol. 68, No. 12, 01.12.2015, p. 963-970.

Research output: Contribution to journalReview article

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abstract = "The differential diagnosis of heavily pigmented melanocytic neoplasms includes melanoma (especially animal type), melanosis of partially or completely regressed melanoma, blue naevus (BN), pigmented Spitzoid lesions, recurrent naevus, combined naevus, pigmented spindle cell naevus, epithelioid blue naevus of the Carney complex/pigmented epithelioid melanocytoma, deep penetrating naevus, hyperpigmented scar after surgery of melanoma in which there are also melanophages and hyperpigmentation due to the minocycline, a tattoo or a hyperpigmented scar. Pathologists face challenges when evaluating a pigmented lesion, especially in a small superficial biopsy, because it is difficult to access important histopathological features to differentiate benign versus malignant melanocytic lesions. The histological features that favour a diagnosis of melanoma include dimension (>6 mm), asymmetry, poor circumscription, irregular confluent nests, confluent lentiginous junctional melanocytic proliferation, lack of maturation with descent in the dermis, suprabasal pagetoid melanocytes, asymmetrical distribution of melanin pigment, cytological atypia, dermal mitotic figures, asymmetrical dermal lymphocytic infiltrate and necrosis.",
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AU - Prieto, Victor

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