Compound nevus

Compound nevus
Diagnosis in short
Compound nevus. H&E stain.
Synonyms	compound melanocytic nevus
LM	nests of melanocytes in dermis and epidermis, melanocytes "mature" with depth, usu. no mitoses (occ. superficial), no destruction of surrounding structures, no conspicuous nucleoli, no significant melanocyte enlargement
LM DDx	malignant melanoma (nevoid), junctional nevus, intradermal nevus, dysplastic nevus
Gross	pigment skin lesion, usu. small, regular border, no irregularity in pigmentation
Site	skin - see melanocytic lesions and common nevus
Prevalence	very common
Prognosis	benign
Clin. DDx	pigmented skin lesions
Treatment	none required, may be excised for cosmetic reasons

Compound nevus (abbreviated CN), also compound melanocytic nevus (abbreviated CMN), is a common benign melanocytic lesion.

The compound nevus is in the large group common nevus. In common language, nevus is known as a mole.

General

• Benign.
• Common.
• Arise from junctional nevi and then progress to intradermal nevi.

Clinical - think about malignant melanoma... it should not be like melanoma:

• ABCD = asymmetric, borders (irregular), colour (black), diameter (large).

Microscopic

Features:

• Symmetrical lesion.
• "Matures" with depth.
  • Less cellular with depth.
  • Less nuclear atypia with depth.
  • Smaller cells with depth.
  • Smaller nests with depth.
• Rare mitoses (superficial).
  • No deep mitoses.
• No destruction of surrounding structures.
• No nucleoli.
• In the dermis and epidermis - key feature.
• +/-Adipocytes - uncommon.

DDx:

• Malignant melanoma (nevoid).
• Dysplastic nevus.
• Junctional nevus.
• Intradermal nevus.

Images

• 

  CN - low mag.

• 

  CN - intermed. mag.

• 

  CN - high mag.

• 

  CN - high mag.

• 

  CN - very high mag.

Sign out

SKIN LESION, RIGHT NECK, SHAVE BIOPSY:
- BENIGN COMPOUND NEVUS.

Micro

The sections show melanocytes in the dermis and epidermis. The lesion is symmetrical in its architecture and pigment distribution. There is no pagetoid spread of melanocytes in the epidermis. Superficially, melanocytes are in nests. Melanocytes show no apparent cytologic atypia and mature with depth. No mitotic activity is appreciated. The lesion is completely excised in the plane of section.

Barely compound

The sections show melanocytes predominantly in the dermis. Rare melanocytic nests are seen at the dermal-epidermal junction. There is no pagetoid spread of melanocytes in the epidermis. The lesion is symmetrical in its architecture. Superficially, melanocytes are in nests and pigment is present. The melanocytes mature with depth. No mitotic activity is appreciated. The lesion is present at the margin.

Congenital features present

The sections show melanocytes in the dermis and epidermis. There is no pagetoid spread of melanocytes in the epidermis. Superficially, melanocytes are in nests. Melanocytes show mild nuclear enlargement but mature with depth. Nucleoli are not prominent. Melanocytes are found adjacent to adnexal structures and blood vessels. No mitotic activity is appreciated. The lesion is incompletely excised.

See also

• Melanocytic lesions.