Difference between revisions of "Atypical lentiginous nevus"
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| Width = | | Width = | ||
| Caption = | | Caption = | ||
| Micro = elongated rete ridges (key feature) | | Micro = elongated rete ridges (key feature), diffuse (non-lamellar) superficial dermal fibrosis, mild-to-moderated cytologic atypia | ||
| Subtypes = | | Subtypes = | ||
| LMDDx = [[dysplastic nevus]], [[melanoma in situ]] | | LMDDx = [[dysplastic nevus]], [[melanoma in situ]] | ||
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| ClinDDx = [[melanoma]] | | ClinDDx = [[melanoma]] | ||
}} | }} | ||
'''Atypical lentiginous nevus''', also '''atypical lentiginous nevus of the elderly''', is a [[melanocytic lesion]] associated with old age and 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]].<ref name=pmid10911797>{{Cite journal | last1 = Edwards | first1 = SL. | last2 = Blessing | first2 = K. | title = Problematic pigmented lesions: approach to diagnosis. | journal = J Clin Pathol | volume = 53 | issue = 6 | pages = 409-18 | month = Jun | year = 2000 | doi = | PMID = 10911797 }}</ref><ref>{{Cite journal | last1 = Kossard | first1 = S. | title = Atypical lentiginous junctional naevi of the elderly and melanoma. | journal = Australas J Dermatol | volume = 43 | issue = 2 | pages = 93-101 | month = May | year = 2002 | doi = | PMID = 11982564 }}</ref> | It can be considered a type of [[dysplastic nevus]].<ref name=pmid10911797>{{Cite journal | last1 = Edwards | first1 = SL. | last2 = Blessing | first2 = K. | title = Problematic pigmented lesions: approach to diagnosis. | journal = J Clin Pathol | volume = 53 | issue = 6 | pages = 409-18 | month = Jun | year = 2000 | doi = | PMID = 10911797 }}</ref><ref>{{Cite journal | last1 = Kossard | first1 = S. | title = Atypical lentiginous junctional naevi of the elderly and melanoma. | journal = Australas J Dermatol | volume = 43 | issue = 2 | pages = 93-101 | month = May | year = 2002 | doi = | PMID = 11982564 }}</ref> | ||
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==Microscopic== | ==Microscopic== | ||
Features:<ref name=pmid22421501>{{Cite journal | last1 = Agustí-Mejias | first1 = A. | last2 = Messeguer Badia | first2 = F. | last3 = García Ruiz | first3 = R. | last4 = Oliver Martínez | first4 = V. | last5 = Alegre de Miquel | first5 = V. | title = [Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases]. | journal = Actas Dermosifiliogr | volume = 103 | issue = 5 | pages = 394-400 | month = Jun | year = 2012 | doi = 10.1016/j.ad.2011.10.006 | PMID = 22421501 }}</ref> | Features:<ref name=pmid22421501>{{Cite journal | last1 = Agustí-Mejias | first1 = A. | last2 = Messeguer Badia | first2 = F. | last3 = García Ruiz | first3 = R. | last4 = Oliver Martínez | first4 = V. | last5 = Alegre de Miquel | first5 = V. | title = [Atypical lentiginous nevus: a clinical and histopathologic study of 14 cases]. | journal = Actas Dermosifiliogr | volume = 103 | issue = 5 | pages = 394-400 | month = Jun | year = 2012 | doi = 10.1016/j.ad.2011.10.006 | PMID = 22421501 | URL = http://www.actasdermo.org/en/atypical-lentiginous-nevus-a-clinical/articulo/90149637/?pubmed=true }}</ref> | ||
*Elongated rete ridges - '''key feature'''. | *Elongated rete ridges - '''key feature'''. | ||
*Superficial dermal fibrosis, diffuse (non-lamellar) - '''important'''. | *Superficial dermal fibrosis, diffuse (non-lamellar) - '''important'''. | ||
*Mild-to-moderate cytologic atypia. | *Mild-to-moderate cytologic atypia, focal. | ||
Notes:<ref name=pmid22421501/> | |||
*Rarely dermal nests. | |||
*Mild-to-moderate inflammation. | |||
*Mitoses - never. | |||
*[[Solar elastosis]] - mild-to-moderate. | |||
DDx:<ref name=pmid22421501/> | DDx:<ref name=pmid22421501/> | ||
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*[[Dysplastic nevus]] - lamellar fibrosis. | *[[Dysplastic nevus]] - lamellar fibrosis. | ||
*[[Lentigo simplex]]. | *[[Lentigo simplex]]. | ||
*[[Lentigo maligna]]. | *[[Lentigo maligna]] - more atypia, upward migration of melanocytes, occasional mitoses. | ||
*[[Solar lentigo]]. | *[[Solar lentigo]] - [[solar elastosis]]. | ||
*[[Lentiginous nevus]]. | *[[Lentiginous nevus]]. | ||
===Images=== | |||
*[http://www.actasdermo.org/imatges/403/403v103n05/grande/403v103n05-90149637fig2.jpg ALN (actasdermo.org)].<ref name=pmid22421501/> | |||
==Sign out== | ==Sign out== | ||
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- ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. | - ATYPICAL LENTIGINOUS NEVUS OF THE ELDERY. | ||
-- COMPLETELY EXCISED, (CLEARANCE 2 MM). | -- COMPLETELY EXCISED, (CLEARANCE 2 MM). | ||
</pre> | |||
<pre> | |||
SKIN LESION, CENTRAL BACK, SHAVE EXCISION: | |||
- ATYPICAL LENTIGINOUS NEVUS. | |||
-- COMPLETELY EXCISED, (CLEARANCE 2 MM). | |||
-- MILD CYTOLOGIC ATYPIA. | |||
</pre> | </pre> | ||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
==External links== | |||
*[http://www.dermpedia.org/dermpedia-textbook/compound-nevus-with-atypia Compound nevus with atypia (dermpedia.org)]. | |||
[[Category:Diagnosis]] | [[Category:Diagnosis]] | ||
[[Category:Dermatopathology]] | [[Category:Dermatopathology]] | ||
Latest revision as of 03:29, 11 September 2013
| 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
- Associated with malignant melanoma.[3]
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]
- Lentiginous melanoma.
- Dysplastic nevus - lamellar fibrosis.
- Lentigo simplex.
- Lentigo maligna - more atypia, upward migration of melanocytes, occasional mitoses.
- Solar lentigo - solar elastosis.
- Lentiginous nevus.
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
- ↑ Edwards, SL.; Blessing, K. (Jun 2000). "Problematic pigmented lesions: approach to diagnosis.". J Clin Pathol 53 (6): 409-18. PMID 10911797.
- ↑ Kossard, S. (May 2002). "Atypical lentiginous junctional naevi of the elderly and melanoma.". Australas J Dermatol 43 (2): 93-101. PMID 11982564.
- ↑ 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.
- ↑ 4.0 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.