BOOK
Pathology of Melanocytic Tumors E-Book
Klaus J. Busam | Richard A Scolyer | Pedram Gerami
(2018)
Additional Information
Book Details
Abstract
Constituting a large percentage of everyday diagnostic practice, melanocytic pathology is a complex and challenging area with many difficult-to-diagnose lesions. This highly illustrated reference, written by three of the world’s leading dermatopathologists, provides authoritative guidance in the accurate diagnosis of even the most challenging pigmented skin tumors, helping you avoid pitfalls and recognize mimics.
- Covers nearly every variant of melanocytic tumors you’re likely to see.
- Emphasizes how to arrive at an efficient, accurate diagnosis, and includes dermoscopic findings for optimal diagnostic precision.
- Discusses modern analytic techniques (cytogenetics, molecular studies) and how to use them for diagnosis.
- Includes numerous case examples to illustrate the differential diagnoses and work-up; how to use ancillary techniques, along with their pros, cons, and limitations; and clinical follow-up.
- Presents the knowledge and experience of Klaus Busam, Pedram Gerami, and Richard Scolyer, – three dermatopathologists who are globally renowned for their expertise in melanoma pathology and analysis of melanocytic tumors by modern ancillary diagnostic techniques.
Table of Contents
| Section Title | Page | Action | Price |
|---|---|---|---|
| Front Cover | cover | ||
| IFC_ExCon page | IFC2 | ||
| Pathology of Melanocytic Tumors | i | ||
| Copyright Page | iv | ||
| Dedication | v | ||
| Contributors | vi | ||
| Preface | viii | ||
| Table Of Contents | ix | ||
| I Benign Cutaneous Melanocytic Proliferations | 1 | ||
| 1 Melanotic Macules | 2 | ||
| Outline | 2 | ||
| Solar Lentigo | 2 | ||
| Clinical Features | 2 | ||
| Histopathologic Findings | 2 | ||
| Differential Diagnosis | 4 | ||
| Lentigo Simplex | 5 | ||
| Clinical Features | 5 | ||
| Histopathologic Findings | 5 | ||
| Differential Diagnosis | 5 | ||
| Miscellaneous Melanotic Macules | 5 | ||
| Primary Acquired Melanosis | 7 | ||
| References | 7 | ||
| 2 Acquired Melanocytic Nevi | 8 | ||
| Keywords | 8.e1 | ||
| Outline | 8 | ||
| Origin of Melanocytes | 8 | ||
| Ultraviolet (UV) Radiation and Nevi | 8 | ||
| Clinical Findings | 8 | ||
| Common Acquired Junctional Melanocytic Nevi | 8 | ||
| Common Acquired Compound Melanocytic Nevi | 9 | ||
| Common Acquired Intradermal Melanocytic Nevi | 9 | ||
| Histopathologic Findings | 9 | ||
| Common Acquired Junctional Melanocytic Nevi | 9 | ||
| Acquired Compound and Intradermal Melanocytic Nevi | 10 | ||
| Halo and Eczematous Nevi | 14 | ||
| Dysplastic Nevi | 14 | ||
| Major Criteria | 17 | ||
| Minor Criteria | 17 | ||
| Differential Diagnosis | 22 | ||
| Melanocytic Nevus With Atypical Features Versus Melanoma In Situ Associated With a Nevus | 22 | ||
| Dysplastic Nevus Versus Melanoma | 22 | ||
| References | 24 | ||
| 3 Congenital Melanocytic Nevi | 26 | ||
| Keywords | 26.e1 | ||
| Outline | 26 | ||
| Clinical Findings | 26 | ||
| Dermoscopy | 28 | ||
| Histopathologic Findings | 28 | ||
| Nevus Spilus | 30 | ||
| Proliferative Nodules | 30 | ||
| Molecular Findings | 31 | ||
| Cytogenetics of Proliferative Nodules | 34 | ||
| Differential Diagnosis | 34 | ||
| Prognosis and Treatment | 34 | ||
| References | 36 | ||
| 4 Spitz Nevi | 37 | ||
| Keywords | 37.e1 | ||
| Outline | 37 | ||
| Clinical Findings | 37 | ||
| Histopathologic Findings | 38 | ||
| Histopathologic Variants of Spitz Nevi and Related Differential Diagnosis | 40 | ||
| Angiomatoid Spitz Nevus | 41 | ||
| Desmoplastic Spitz Nevus | 42 | ||
| Epithelioid Spitz Nevus | 42 | ||
| Pagetoid Spitz Nevus | 42 | ||
| Pigmented Spindle Cell Nevus | 43 | ||
| Plexiform Spitz Nevus | 45 | ||
| Other Variants of Spitz Nevus | 45 | ||
| Molecular Findings and Correlation With Histopathologic Phenotype | 45 | ||
| HRAS Aberrations | 45 | ||
| BAP1-Deficient/Inactivated Spitzoid Neoplasms | 45 | ||
| Spitzoid Neoplasms With Deletions in 6q23 | 49 | ||
| Fusion-Related Spitzoid Neoplasms | 49 | ||
| Spitz Nevus Versus Atypical Spitz Tumor Versus Spitzoid Melanoma | 56 | ||
| Spitzoid Melanoma | 56 | ||
| Atypical Spitz Tumor | 56 | ||
| Ancillary Methods for Diagnosis | 56 | ||
| Immunohistochemistry | 56 | ||
| Cytogenetic Studies | 56 | ||
| Gene Expression Studies | 56 | ||
| Mutation Analysis | 57 | ||
| Prognosis and Treatment | 57 | ||
| References | 59 | ||
| 5 Blue Nevi and Dermal Melanocytosis | 61 | ||
| Keywords | 61.e1 | ||
| Outline | 61 | ||
| Dermal Melanocytosis | 61 | ||
| Clinical Variants | 61 | ||
| Mongolian Spot. | 61 | ||
| Nevus of Ota (a.k.a. “Oculo-Dermal Melanocytosis” or “Nevus Fuscoceruleus Ophthalmomaxillaris”). | 61 | ||
| Nevus of Ito (a.k.a. “Nevus Fuscoceruleus Acromiodeltoideus”). | 62 | ||
| Nevus of Sun (Nevus Fusco-Caeruleus Zygomaticus) and Nevus of Hori (Acquired Bilateral Nevus of Ota-Like Macules). | 62 | ||
| Acquired Dermal Melanocytosis of the Face and Extremities. | 62 | ||
| Dermal Melanocyte Hamartoma. | 62 | ||
| Histopathologic Findings | 62 | ||
| Blue Nevi | 63 | ||
| Common Blue Nevus | 63 | ||
| Clinical Findings and Variants of Common Blue Nevus. | 63 | ||
| Histopathologic Findings. | 63 | ||
| Differential Diagnosis of Common Blue Nevus | 64 | ||
| Blue Nevus Versus Melanocytosis. | 64 | ||
| Blue Nevus Versus Melanosis. | 64 | ||
| Blue Nevus Versus Combined Nevus. | 65 | ||
| Blue Nevus Versus Blue Nevi-Like Melanoma. | 65 | ||
| Blue Nevus Versus Metastatic Blue Nevi-Like Melanoma. | 65 | ||
| Sclerosing Blue Nevus | 65 | ||
| Histopathologic Findings. | 65 | ||
| Differential Diagnosis of Sclerosing Blue Nevus | 65 | ||
| Sclerosing Blue Nevi Versus Dermatofibroma. | 65 | ||
| Sclerosing Blue Nevi Versus Other Sclerosing Nevus. | 65 | ||
| Sclerosing Blue Nevi Versus Desmoplastic Melanoma. | 66 | ||
| Hypomelanotic or Amelanotic Blue Nevus | 66 | ||
| Hypermelanotic Blue Nevus | 66 | ||
| Clear Cell or Balloon Cell Blue Nevus | 67 | ||
| Blue Nevus With Epithelioid Cell Features | 67 | ||
| Differential Diagnosis of Blue Nevus With Epithelioid Cell Features | 67 | ||
| Epithelioid Blue Nevi Versus Nodular Dermal Tumoral Melanosis. | 67 | ||
| Blue Nevi With Epithelioid Cell Features Versus Primary Dermal Blue Nevi–Like Melanoma. | 67 | ||
| Epithelioid Blue Nevi Versus Metastatic Blue Nevi-Like Melanoma. | 68 | ||
| Blue Nevi With Epithelioid Cells Versus Pigmented Epithelioid Melanocytoma. | 68 | ||
| Blue Nevi With Epithelioid Cell Features Versus Pigmented Epithelioid Spitz Nevus. | 68 | ||
| “Compound Blue Nevus” | 68 | ||
| Combined Blue Nevus | 68 | ||
| Traumatized Blue Nevus | 68 | ||
| Cellular Blue Nevus | 69 | ||
| Clinical Findings. | 69 | ||
| Histopathologic Findings. | 69 | ||
| Atypical Cellular Blue Nevus | 71 | ||
| Differential Diagnosis of Cellular Blue Nevus. | 71 | ||
| Cellular Blue Nevi Versus Primary Melanoma (Associated With or Simulating a Cellular Blue Nevus). | 72 | ||
| Cellular Blue Nevi Versus Metastatic Melanoma. | 73 | ||
| Cellular Blue Nevi Versus Clear Cell Sarcoma. | 73 | ||
| Cellular Blue Nevi Versus Pigmented Dermatofibrosarcoma Protruberans (DFSP). | 74 | ||
| Cellular Blue Nevi Versus Malignant Melanotic Schwannian Tumor. | 74 | ||
| Plaque-Type Blue Nevus | 74 | ||
| Clinical Findings. | 74 | ||
| Histopathologic Findings. | 74 | ||
| Neurocristic Hamartoma | 76 | ||
| Clinical Findings. | 76 | ||
| Histopathologic Findings. | 78 | ||
| Differential Diagnosis. | 78 | ||
| Extracutaneous Blue Nevi | 78 | ||
| Nodal Blue Nevus. | 78 | ||
| Mucosal or Visceral Blue Nevi. | 78 | ||
| References | 79 | ||
| 6 Deep Penetrating Nevi | 80 | ||
| Keywords | 80.e1 | ||
| Outline | 80 | ||
| Clinical Findings | 80 | ||
| Histopathologic Findings | 80 | ||
| Immunohistochemical Findings | 83 | ||
| Molecular Findings | 83 | ||
| Differential Diagnosis | 83 | ||
| Deep Penetrating Nevus Versus Plexiform Pigmented Spindle Cell or Spitz Nevus | 83 | ||
| Deep Penetrating Nevus Versus Blue Nevus | 86 | ||
| Deep Penetrating Nevus Versus Deep Penetrating Nevus–Like Melanoma | 86 | ||
| Deep Penetrating Nevus Versus Tumoral Melanosis | 87 | ||
| Prognosis and Treatment | 87 | ||
| References | 89 | ||
| 7 Melanocytic Nevi of Special Sites | 90 | ||
| Abstract | 90.e1 | ||
| Keywords | 90.e1 | ||
| Outline | 90 | ||
| Ear Nevi | 90 | ||
| II Primary Cutaneous Melanoma | 130 | ||
| 11 Histopathologic Diagnosis of Melanoma | 131 | ||
| Keywords | 131.e1 | ||
| Outline | 131 | ||
| ABCD Parameters and Cytology | 131 | ||
| Asymmetry | 131 | ||
| Irregular Borders | 131 | ||
| Variation in Color | 131 | ||
| Diameter | 131 | ||
| Cytology | 133 | ||
| Synthesis of Findings and Clinicopathologic Correlation | 133 | ||
| Diagnosis of Melanoma in Situ | 135 | ||
| Differential Diagnosis of Melanoma in Situ | 135 | ||
| Diagnosis of Invasive Melanoma | 135 | ||
| Variants of Melanoma | 137 | ||
| Molecular Classification of Melanoma | 138 | ||
| Ancillary Methods for the Diagnosis of Melanoma | 138 | ||
| Melanocytic Proliferations Reported Without a Precise Diagnosis | 138 | ||
| Atypical Intraepidermal Melanocytic Proliferations | 138 | ||
| MELTUMP | 139 | ||
| References | 139 | ||
| 12 Lentigo Maligna Melanoma | 140 | ||
| Abstract | 140.e1 | ||
| Keywords | 140.e1 | ||
| Outline | 140 | ||
| Nomenclature | 140 | ||
| Clinical Findings | 140 | ||
| Obtaining a Biopsy Specimen | 141 | ||
| Histopathologic Findings | 142 | ||
| Lentigo Maligna Melanoma In Situ | 142 | ||
| Lentigo Maligna Melanoma | 143 | ||
| Ancillary Tests | 148 | ||
| Clinical and Dermoscopic Images | 148 | ||
| Immunohistochemistry | 148 | ||
| Molecular Tests | 150 | ||
| Differential Diagnosis | 151 | ||
| Melanocyte Hyperplasia of Sun-Damaged Skin (aka Solar Melanocytosis) Versus Lentigo Maligna | 151 | ||
| Solar Lentigo, Pigmented Seborrheic Keratosis, Lichenoid Keratosis, and Pigmented Actinic Keratosis Versus Lentigo Maligna | 151 | ||
| Junctional Melanocytic Nevus Versus Lentigo Maligna | 152 | ||
| Lentiginous Compound Melanocytic Nevus Versus Lentigo Maligna Melanoma or Lentigo Maligna Colliding With a Nevus | 154 | ||
| Lentigo Maligna Melanoma Versus Lentiginous Melanoma of Skin With Low Cumulative Sun Damage | 155 | ||
| Inflamed Scar Versus Lentigo Maligna Melanoma With Desmoplastic Invasive Tumor | 155 | ||
| Intrafollicular Melanoma In Situ Versus Invasive Melanoma or Satellite Lesion | 155 | ||
| Surgical/Clinical Management and Margin Assessment | 156 | ||
| References | 156 | ||
| 13 Superficial Spreading Melanoma | 158 | ||
| Keywords | 158.e1 | ||
| Outline | 158 | ||
| Clinical Findings | 158 | ||
| Histopathologic Findings | 158 | ||
| Differential Diagnosis | 165 | ||
| Superficial Spreading Melanoma Versus Dysplastic Nevus | 165 | ||
| Distinction of Superficial Spreading Melanoma From Superficial Spitz Nevi | 165 | ||
| Distinction of Superficial Spreading Melanoma Versus Other Melanomas | 166 | ||
| Molecular and Cytogenetic Findings | 166 | ||
| Fluorescence In Situ Hybridization for the Diagnosis of Superficial Spreading Melanoma | 166 | ||
| Gene Expression Profiling | 166 | ||
| References | 166 | ||
| 14 Acral and Subungual Melanoma | 168 | ||
| Keywords | 168.e1 | ||
| Outline | 168 | ||
| General Comments | 168 | ||
| Site-Specific Microanatomy of Volar Skin and Correlations With Dermoscopy | 168 | ||
| Microanatomy of the Nail Apparatus | 168 | ||
| Melanonychia | 169 | ||
| Clinical Findings | 169 | ||
| Pathologic Findings | 171 | ||
| Melanoma of Volar Skin (Palmar or Plantar Melanoma) | 171 | ||
| Subungal Melanoma | 173 | ||
| Molecular Findings | 173 | ||
| Differential Diagnosis and Pitfalls | 173 | ||
| Differential Diagnosis | 177 | ||
| Melanoma of Volar Skin Versus Melanocytic Nevus of Volar Skin. | 177 | ||
| Subungual Melanoma Versus Subungual Melanocytic Nevus. | 177 | ||
| Subungual Melanoma In Situ Versus Subungual Melanotic Macule. | 177 | ||
| Amelanotic Acral and Subungual Melanoma Versus Nonmelanocytic Tumors. | 178 | ||
| Syringotropic Acral Melanoma In Situ Versus Invasive Melanoma. | 178 | ||
| Pitfalls | 178 | ||
| Difficulty of Measuring Tumor Thickness. | 178 | ||
| Sampling Problems. | 179 | ||
| Treatment and Margin Assessment | 179 | ||
| Prognosis | 180 | ||
| References | 180 | ||
| 15 Nodular Melanoma | 181 | ||
| Keywords | 181.e1 | ||
| Outline | 181 | ||
| Clinical Findings | 181 | ||
| Histopathologic Findings | 184 | ||
| Nodular Melanoma Associated With In Situ Melanoma | 184 | ||
| Nodular Melanoma Not Associated With In Situ Melanoma | 186 | ||
| Differential Diagnosis | 188 | ||
| Molecular Findings | 188 | ||
| Treatment and Prognosis | 189 | ||
| Comment | 189 | ||
| References | 189 | ||
| 16 Desmoplastic Melanoma | 190 | ||
| Keywords | 190.e1 | ||
| Outline | 190 | ||
| Clinical Findings | 190 | ||
| Histopathologic Findings | 190 | ||
| Pure Desmoplastic Melanoma | 195 | ||
| Mixed Desmoplastic Melanoma | 197 | ||
| Immunohistochemical Findings | 197 | ||
| Molecular Findings | 197 | ||
| Differential Diagnosis | 199 | ||
| Desmoplastic Melanoma Versus Fibrosing Nonmelanocytic Benign Lesions | 199 | ||
| Desmoplastic Melanoma Versus Dermal Scar | 199 | ||
| Desmoplastic Melanoma Versus Dermatofibroma | 200 | ||
| Desmoplastic Melanoma Versus Neurofibroma | 200 | ||
| Desmoplastic Melanoma Versus Plexiform Schwannoma | 201 | ||
| Desmoplastic Melanoma Versus Desmoplastic Cellular Neurothekeoma | 202 | ||
| Desmoplastic Melanoma Versus Desmoplastic Melanocytic Nevus | 202 | ||
| Desmoplastic Melanoma Versus Sclerosing Spitz Nevus | 203 | ||
| Desmoplastic Melanoma Versus Sclerosing Blue Nevus | 204 | ||
| Desmoplastic Melanoma Versus Other Nevi With Sclerosis | 206 | ||
| Desmoplastic Melanoma Versus Nonmelanocytic Malignant Tumors | 206 | ||
| Desmoplastic Melanoma Versus Desmoplastic Spindle Cell Carcinoma | 206 | ||
| Desmoplastic Melanoma Versus Desmoplastic Leiomyosarcoma | 206 | ||
| Desmoplastic Melanoma Versus Spindle Cell Atypical Fibroxanthoma (AFX) or Undifferentiated Dermal Sarcoma | 206 | ||
| Desmoplastic Melanoma Versus Malignant Peripheral Nerve Sheath Tumor | 206 | ||
| Clinical Management and Prognosis | 206 | ||
| References | 207 | ||
| 17 Nevoid Melanoma | 208 | ||
| Keywords | 208.e1 | ||
| Outline | 208 | ||
| Clinical Findings | 208 | ||
| Histopathologic Findings | 208 | ||
| Molecular Findings | 212 | ||
| Differential Diagnosis | 212 | ||
| Mitotically Active Melanocytic Nevus | 212 | ||
| Cellular/Proliferative Nodule in a Nevus | 212 | ||
| Superficial Spreading Melanoma With a Nevoid Invasive Component | 212 | ||
| Lentiginous Melanomas With Nevoid Invasive Component | 213 | ||
| References | 215 | ||
| 18 Spitzoid Melanoma | 216 | ||
| Keywords | 216.e1 | ||
| Outline | 216 | ||
| Clinical Findings | 216 | ||
| Histopathologic Findings | 216 | ||
| Immunohistochemical Findings | 223 | ||
| Molecular Findings | 223 | ||
| Histopathologic-Genomic Correlations | 224 | ||
| Differential Diagnosis | 225 | ||
| Spitz Nevus and Atypical Spitz Tumor | 225 | ||
| Melanomas With Spitzoid Features | 225 | ||
| Melanoma With Spitzoid Subclones. | 225 | ||
| Conventional Melanoma Arising in a Spitz Nevus. | 225 | ||
| Nevoid Melanoma. | 225 | ||
| Treatment and Prognosis | 225 | ||
| References | 225 | ||
| 19 Melanoma Arising in Association With and/or Simulating a Blue Nevus | 226 | ||
| Keywords | 226.e1 | ||
| Outline | 226 | ||
| Clinical Findings | 226 | ||
| Histopathologic Findings | 226 | ||
| Melanoma Associated With a Common Blue Nevus or Melanocytosis (Nevus of Ota or Ito) | 226 | ||
| Melanoma Associated With a Cellular Blue Nevus | 226 | ||
| Melanoma Simulating a Common Blue Nevus | 228 | ||
| Melanoma Simulating a Blue Nevus With Epithelioid Cell Features of Pigmented Epithelioid Melanocytoma | 230 | ||
| Melanoma Simulating a Cellular Blue Nevus | 230 | ||
| Immunohistochemical Findings | 230 | ||
| Molecular Findings | 230 | ||
| Differential Diagnosis | 230 | ||
| Prognosis and Treatment | 233 | ||
| References | 234 | ||
| 20 Uncommon Variants of Melanoma and Collision Scenarios | 235 | ||
| Keywords | 235.e1 | ||
| Outline | 235 | ||
| Histopathologic Findings and Differential Diagnosis | 235 | ||
| Balloon Cell/Clear Cell Melanoma | 235 | ||
| Deep Penetrating Nevus-Like (Plexiform) Melanoma | 235 | ||
| Primary Dermal Melanoma | 235 | ||
| Follicular Melanoma | 236 | ||
| Rhabdoid Melanoma | 236 | ||
| Sarcomatoid Melanoma | 236 | ||
| Signet Ring Cell Melanoma | 236 | ||
| Small Cell Melanoma | 236 | ||
| Undifferentiated Melanoma | 236 | ||
| Verrucous (Papillomatous Keratotic Variant of) Melanoma | 237 | ||
| Melanoma Associated With Pseudoepitheliomatous Epidermal Hyperplasia | 237 | ||
| Melanoma With Pseudovascular Changes | 238 | ||
| Melanoma With Epithelial Features | 238 | ||
| Spindle Cell Melanoma | 238 | ||
| Polypoid Melanoma | 241 | ||
| Collision Scenarios | 241 | ||
| Melanoma Colliding With a Basal Cell Carcinoma | 241 | ||
| Melanoma Colliding With a Squamous Proliferation | 241 | ||
| References | 243 | ||
| 21 Pediatric Melanoma | 244 | ||
| Outline | 244 | ||
| Clinical Findings | 244 | ||
| Adult Subtype | 244 | ||
| Spitzoid Subtype | 244 | ||
| Large/Giant Congenital Nevi–Associated Subtype | 244 | ||
| Histopathologic Findings | 245 | ||
| Adult Subtype | 245 | ||
| Spitzoid Subtype | 245 | ||
| Large/Giant Congenital Nevus–Associated Subtype | 247 | ||
| Molecular Findings | 247 | ||
| Adult Subtype | 247 | ||
| Spitzoid Subtype | 248 | ||
| Giant/Large Congenital Nevus–Associated Subtype | 248 | ||
| Differential Diagnosis | 248 | ||
| Prognosis | 249 | ||
| Treatment | 251 | ||
| References | 251 | ||
| III Primary Extracutaneous Melanocytic Proliferations | 253 | ||
| 22 Conjunctival Melanocytic Proliferations | 254 | ||
| Keywords | 254.e1 | ||
| Outline | 254 | ||
| Complexion-Associated Melanosis | 254 | ||
| IV Metastatic Melanoma | 313 | ||
| 27 Metastatic Melanoma | 314 | ||
| Keywords | 314.e1 | ||
| Outline | 314 | ||
| Clinical Findings | 314 | ||
| Pathologic Findings | 314 | ||
| Locoregional Metastases | 315 | ||
| Metastatic Melanoma in Regional Lymph Nodes. | 315 | ||
| Sentinel lymph node biopsy. | 316 | ||
| Pathologic examination of sentinel lymph nodes. | 316 | ||
| Locoregional Metastatic Melanoma to Skin and/or Soft Tissue. | 317 | ||
| Metastatic Melanoma to Distant Sites | 317 | ||
| Metastatic Melanoma With Unknown/Undetectable Primary Site | 319 | ||
| Ancillary Studies | 319 | ||
| Immunohistochemistry (IHC) | 319 | ||
| Molecular Pathology | 320 | ||
| Differential Diagnosis | 320 | ||
| Metastatic Melanoma in Lymph Node Versus Other | 320 | ||
| Metastatic Melanoma Versus Nodal Melanocytic Nevus | 320 | ||
| Metastatic Melanoma Versus Nodal Melanosis or Nonmelanotic Pigment in Lymph Node (LN) | 322 | ||
| Metastatic Melanoma Versus Nonmalignant Immunoreactive Cells in LN | 322 | ||
| Metastatic Melanoma Versus Nonmelanocytic Tumor in LN | 323 | ||
| Metastatic Cutaneous Melanoma Versus Metastatic Melanoma of Soft Parts (Clear Cell Sarcoma) | 323 | ||
| Metastatic Melanoma to Skin and Soft Tissue Versus Other | 323 | ||
| Metastatic Melanoma to the Skin Versus Primary Melanoma | 323 | ||
| Metastatic Melanoma Versus Melanocytic Nevus | 325 | ||
| Metastatic Melanoma to the Skin and Soft Tissue Versus Primary Nonmelanocytic Tumor | 327 | ||
| Metastatic Melanoma Versus Clear Cell Sarcoma | 327 | ||
| Metastatic Melanoma Versus Melanotic Schwannoma | 327 | ||
| Metastatic Melanoma to the Skin and Soft Tissue Versus Metastatic Nonmelanocytic Tumor | 327 | ||
| Metastatic Melanoma to Visceral Sites, Brain, or Bone | 327 | ||
| Metastatic Melanoma Versus Nonmelanocytic (Primary or Metastatic) Tumor | 327 | ||
| Metastatic Melanoma Versus Primary Mucosal or Visceral Melanoma | 328 | ||
| Melanosis Associated With Metastatic Melanoma | 328 | ||
| Prognosis and Treatment of Metastatic Melanoma | 328 | ||
| Locoregional Metastases (AJCC Stage III) | 328 | ||
| Distant Metastases (AJCC Stage IV Disease) | 329 | ||
| References | 329 | ||
| V Ancillary Studies | 330 | ||
| 28 Dermoscopy for Dermatopathologists | 331 | ||
| Abstract | 331.e1 | ||
| Keywords | 331.e1 | ||
| Outline | 331 | ||
| Using Dermoscopy to Improve Histologic Analysis: the Role of the Clinician | 332 | ||
| Adding Dermoscopic Information and/or Images to the Pathology Requisition Form | 332 | ||
| Marking the Area of Concern | 333 | ||
| Using Dermoscopy to Improve Histologic Analysis: the Role of the Pathologist | 333 | ||
| Ex Vivo Dermoscopy | 333 | ||
| Knowing the Dermoscopic Structures and Colors and Their Histopathologic Correlates | 333 | ||
| Colors in Dermoscopy. | 334 | ||
| Dermoscopic Structures Encountered in Melanocytic Neoplasms. | 334 | ||
| Dermoscopic Features With Special Relevance for the Dermatopathologist | 344 | ||
| Conclusion | 345 | ||
| References | 346 | ||
| 29 Immunohistochemistry for the Diagnosis of Melanocytic Proliferations | 348 | ||
| Keywords | 348.e1 | ||
| Outline | 348 | ||
| The Reagents | 348 | ||
| Differentiation Markers | 348 | ||
| S100. | 348 | ||
| GP100 (PMEL). | 348 | ||
| Tyrosinase. | 350 | ||
| TRP1. | 351 | ||
| TRP2. | 351 | ||
| Melan-A/MART1. | 351 | ||
| MITF. | 352 | ||
| SOX10. | 352 | ||
| PNL2. | 353 | ||
| Biomarkers | 354 | ||
| Ki-67. | 354 | ||
| PHH3. | 354 | ||
| P16. | 355 | ||
| BAP1. | 355 | ||
| ALK. | 356 | ||
| NTRK. | 356 | ||
| SAC. | 357 | ||
| 5-hmC. | 357 | ||
| H3K27me3. | 357 | ||
| PRAME. | 358 | ||
| Mutation Antigens | 358 | ||
| BRAFV600E. | 358 | ||
| RASQ61R. | 358 | ||
| HRAS. | 359 | ||
| Immune-Response Score | 359 | ||
| PD1. | 359 | ||
| PD-L1. | 359 | ||
| Basic Applications of Immunohistochemistry | 359 | ||
| Visualization of Melanocytes | 359 | ||
| Immunohistochemistry for the Distinction of a Melanocytic from Nonmelanocytic Tumor | 360 | ||
| Immunohistochemistry for the Distinction of a Melanocytic Nevus from Melanoma | 360 | ||
| Expression Profile of p16, HMB45 and Ki-67. | 361 | ||
| Expression of Cancer Testis Antigens for the Distinction of Nevi from Melanoma. | 361 | ||
| For the Distinction of a Desmoplastic Spitz Nevus from Desmoplastic Melanoma. | 362 | ||
| For the Distinction of Nodal Nevus from Metastatic Melanoma. | 362 | ||
| Distinction of Proliferative Nodule from Pediatric Nodular Melanoma. | 362 | ||
| Immunohistochemistry for Treatment Selection and/or Staging Purposes | 362 | ||
| References | 362 | ||
| 30 Molecular Techniques | 364 | ||
| Keywords | 364.e1 | ||
| Outline | 364 | ||
| Basic Terms and Principles | 364 | ||
| Polymerase Chain Reaction | 366 | ||
| Endpoint Polymerase Chain Reaction | 366 | ||
| Quantitative Polymerase Chain Reaction | 366 | ||
| Gene-Expression–Based Assays | 366 | ||
| DNA Sequencing | 367 | ||
| Sanger Sequencing | 367 | ||
| Next-Generation Sequencing | 367 | ||
| Assays to Detect DNA Copy Number Alterations | 370 | ||
| Array Comparative Genomic Hybridization | 370 | ||
| Single Nucleotide Polymorphism—Arrays and Molecular Inversion Probes | 371 | ||
| Fluorescence In Situ Hybridization | 371 | ||
| Diagnostic Use of Molecular Methods | 372 | ||
| References | 372 | ||
| 31 Clinical, Dermoscopic, Pathologic, and Molecular Correlations | 374 | ||
| Keywords | 374.e1 | ||
| Outline | 374 | ||
| Clinical History and Dermoscopy | 374 | ||
| Immunohistochemistry | 374 | ||
| Molecular Methods | 378 | ||
| Cytogenetics: Fluorescence In Situ Hybridization and Comparative Genomic Hybridization | 378 | ||
| mRNA Expression Profiling | 381 | ||
| References | 384 | ||
| VI Prognosis, Staging, and Reporting of Melanoma | 385 | ||
| 32 Prognosis, Staging, and Reporting of Melanomas | 386 | ||
| Keywords | 386.e1 | ||
| Outline | 386 | ||
| Clinical Parameters | 386 | ||
| Histopathologic Parameters | 386 | ||
| Tumor Thickness | 386 | ||
| Partial Biopsy. | 386 | ||
| Ulceration. | 387 | ||
| Epidermal Hyperplasia. | 387 | ||
| Adnexotropism/Periadnexal Extension. | 388 | ||
| Lymphatic Invasion and/or Satellites. | 388 | ||
| Fragmentation and Tangential Sectioning. | 388 | ||
| Ulceration | 388 | ||
| Tumor Mitotic Rate | 389 | ||
| Clark Level | 389 | ||
| Microsatellites | 391 | ||
| Tumor-Infiltrating Lymphocytes | 391 | ||
| Blood Vessel and Lymphatic Invasion | 392 | ||
| Neurotropism | 392 | ||
| Regression | 392 | ||
| Staging of Melanoma | 392 | ||
| Reporting of Melanoma | 393 | ||
| Primary Melanoma | 393 | ||
| Metastatic Melanoma in Lymph Node | 395 | ||
| Distant Metastases | 395 | ||
| Reporting Format. | 395 | ||
| Reports With No Definitive Diagnosis. | 395 | ||
| References | 396 | ||
| VII Margin Assessment of Melanomas | 397 | ||
| 33 Margin Assessment of Cutaneous Melanoma | 398 | ||
| Keywords | 398.e1 | ||
| Outline | 398 | ||
| Guidelines for Melanoma Margins | 398 | ||
| Tissue Processing and Margin Review | 399 | ||
| Conventional Elliptical Excisions | 400 | ||
| Mohs Surgery | 401 | ||
| Staged Excision | 401 | ||
| Pitfalls in Margin Assessment | 403 | ||
| Margin Reporting | 403 | ||
| References | 406 | ||
| Index | 407 | ||
| A | 407 | ||
| B | 407 | ||
| C | 407 | ||
| D | 408 | ||
| E | 409 | ||
| F | 409 | ||
| G | 409 | ||
| H | 409 | ||
| I | 409 | ||
| J | 409 | ||
| K | 409 | ||
| L | 409 | ||
| M | 410 | ||
| N | 412 | ||
| O | 412 | ||
| P | 412 | ||
| Q | 413 | ||
| R | 413 | ||
| S | 413 | ||
| T | 414 | ||
| U | 414 | ||
| V | 414 | ||
| W | 414 | ||
| Z | 414 | ||
| IBC_Clinical Key ad | IBC1 |