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< Current issue
Dermatopathology: Practical & Conceptual January - March 2001
>
Evolution In Thinking: Criteria for Histopathologic Diagnosis of Melanoma, 1947–2000: A Critique in Historical Perspective
Mary Aldrene L. Tan, M.D.
A. Bernard Ackerman, M.D.
Introduction
Becker and Obermayer
Ormsby and Montgomery
Lever
Allen
Percival, Montgomery, and Dodds
Montgomery
Pinkus and Mehregan
Wayte
Clark and Mihm
Milne
Smith
Sanderson
Smith
Price, Rywlin, and Ackerman
Pinkus and Mehregan
Ackerman and Su
Kamino and Ackerman
Domonkos, Arnold, and Odom
Roses, Harris, and Ackerman
MacKie
Okun, Edelstein, and Fisher
McCarthy
et al.
Clark
Kirkham
Weedon and Strutton
Fitzpatrick
et al.
Murphy
Mehregan
et al.
Weedon
Elder and Elenitsas
Barnhill
Langley, Fitzpatrick, and Sober
Langley
et al.
Maize
et al.
Dewan and Ackerman
Farmer and Hood
Conclusion
SEE ALSO
-
melanoma
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Percival, Montgomery, and Dodds
"The following criteria indicate malignant nature of the tumour [melanoma]: frequent and atypical mitoses, the overall large size of the cells and their lack of uniformity, large hyperchromatic nuclei, fusion of cells. Large amounts of pigment in the lesion, invasion of the epidermis by tumour cells, marked junctional activity at the periphery of the lesion, and a marked lymphocytic reaction in the surrounding dermis."
Percival GH, Montgomery GL, Dodds TC.
Atlas of histopathology of the skin.
2nd Edition. Maryland: The Williams and Wilkins Co., 1962:406.
Brief Critique
Of the criteria enumerated, only mitotic figures (some of them abnormal), nuclear atypia, and presence of melanocytes above the dermo-epidermal junction have merit in regard to specific diagnosis of melanoma. But none of them and all of them do not facilitate differentiation of melanoma from some examples of Spitz's nevus. Some precepts of the authors are without merit for specific diagnosis of melanoma, among them fusion of cells, abundant pigment, and junctional activity.
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