Last major update: November 2008 - next update November 2009
Revised: 26 October 2009
Author: Nat Pernick, M.D., PathologyOutlines.com, Inc.
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
● First descried by Reed (Semin Oncol 1975;2:119)
● Controversial topic - concept is not universally accepted
● Introduced to embrace the concept that a subset of invasive melanomas is characterized by lesser cytologic atypia and a better prognosis than conventional melanomas of the same thickness
● Cells are more atypical than nevi but less atypical than classic melanoma
● Also called borderline melanocytic lesion
● Usually on trunk of adults in 20ís and 30ís (Cancer Treat Rev 2002;28:219)
Treatment and prognosis
● Better prognosis than other melanomas, even with infiltration of reticular dermis (Hum Pathol 1986;17:796)
● Plaque or nodule, fleshy, dark brown or blue-black, up to 1 cm
● May resemble an epidermal cyst†††††††††††††††††††††
● Expansive nodule in vertical growth phase that fills papillary dermis and may extend into reticular dermis
● Usually uniform cells with mild to moderate atypia that resemble nevus cells but are moderately enlarged with irregular chromatin and increased N/C ratios
● Growth displaces surrounding structures and remnants of residual benign nevus are often present
● Equivalent to at least a level III melanoma due to extent of dermal invasion
● May have perineural invasion and mitotic figures, but usually does not invade subcutaneous fat; no necrosis, no maturation
Nodular tumor filling papillary dermis†††††††††† Halo variant††††††††††††††††††††††††††††††††††††††††† Ki-67 in this (Fig C) and
††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††††† other melanocytic lesions
● Ki-67 and p53 values are intermediate between compound or Spitz nevi and superficial spreading melanoma (Mod Path 2003;16:525)
● Nevoid melanoma - more mitotic figures, usually no residual nevus
End of Skin-Melanocytic Tumors > Minimal deviation melanoma
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