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Skin-Melanocytic tumors
Lentiginous nevus
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Revised: 18 September 2009, last major update November 2008
Copyright: (c) 2005-2009, PathologyOutlines.com, Inc.
Terminology
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● See also speckled lentiginous nevus
Clinical
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● Often benign mole with increase in size, formation of irregular borders or peripheral change in color
● May be due to “reactivation” of radial proliferation
● Note: atypia often present in childhood acral lesions (Pediatr Dev Pathol 1998;1:388)
Treatment and prognosis
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● Benign, but complete excision is recommended due to histologic overlap with melanoma in situ
Clinical description
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● Usually 5 mm or less
Micro description
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● “Shoulder” area of lentiginous junctional melanocytic proliferation beyond lateral border of underlying dermal nevus
● Elongation of rete ridges with small nests of melanocytes at tips of rete
● Individual unit melanocytes extending along the sides of the rete, often mild lymphohistiocytic infiltrate with pigment incontinence
● No atypia, no pagetoid spread, no dermal fibrosis
● Acral lesions: resemble dysplastic nevus due to elongation of rete ridges, continuous proliferation of melanocytes at dermoepidermal junction, single scattered melanocytes or less commonly small clusters within the upper epidermis, poor or absent lateral circumscription, melanocytes with abundant pale cytoplasm and round/oval, sometimes hyperchromatic nuclei and prominent nucleoli present at the dermoepidermal junction; however, unlike dysplastic nevi, they lack anastomosing rete ridges, cytological atypia and well-formed lamellar fibroplasia (Histopathology 1995;27:549)
Differential Diagnoses
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● Lentigines - no nests, may be nevi if examine serial sections (Am J Dermatopathol 1985;7 Suppl:5)
● Dysplastic nevi
● Superficial spreading or lentiginous melanoma - pagetoid lateral spread, mitotic activity in deep dermis, no maturation (Mod Path 2005;18:1397)
End of Skin-Melanocytic Tumors > Lentiginous nevus
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