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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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Price, Rywlin, and Ackerman
"Summary of Morphological Characteristics of Superficial Spreading Malignant Melanoma Capable of Metastasis
I. Poor circumscription of the intraepidermal melanocytic component of the lesion with lateral extension of individual melanocytes.
II. Increased number of melanocytes, solitary and in nests, within and above the epidermal basal-cell layer and within adnexal epithelium (Pagetoid appearance).
III. Marked variation in size and shape of the melanocytic nests, and confluence of melanocytic nests rather than discrete nests.
IV. Absence of maturation of melanocytes with descent into the dermis.
V. Melanocytes with nuclear atypia
VI. Melanocytes in mitosis
VII. Necrosis or degeneration of melanocytes"
Price NM, Rywlin AM, Ackerman AB. Histologic criteria for the diagnosis of superficial spreading malignant melanoma: Formulated on the basis of proven metastatic lesions.
Cancer
1976; 38:243441.
Brief Critique
Although this constellation of criteria for diagnosis of melanoma by conventional microscopy was an improvement over what had been advanced by authors previously, some important criteria were not included, chief among them asymmetry. Between 1976 and 1999, the criteria forged by Ackerman were honed considerably (see pages 1415).
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