Kamino and Ackerman

 

"Criteria for the Histologic Diagnosis of Malignant Melanoma

 
Architectural Pattern:
 
Wide lateral extent of the lesion, i.e., greater than 6 mm
Asymmetry of the lesion
Horizontal extension of atypical melanocytes within the epidermis, beyond the bulk of the intraepidermal and intradermal components of the neoplasm
Increased number of atypical melanocytes, singly and/ or in nests, within the epidermis
Atypical melanocytes at all levels of the epidermis, even the cornified layer
Variation in sizes and shapes of nests of atypical melanocytes within the epidermis; shapes irregular
Confluence of nests of melanocytes within the epidermis and the dermis
Presence of atypical melanocytes in epithelial structures of adnexa
Failure of maturation of atypical melanocytes with prigressive descent into the dermis (i.e., the nuclei do not become smaller)
 
Cytologic Features:
 
Atypical melanocytes
Melanocytes in mitosis (some of them may be atypical)
Necrotic melanocytes"
 
Kamino H, Ackerman AB. Malignant melanoma in situ: The evolution of malignant melanoma within the epidermis. In: Ackerman AB. Pathology of Malignant Melanoma. New York: Masson Publishing USA, Inc., 1981:79.
 

Brief Critique

 
Although the criteria for specific diagnosis of melanoma proposed by Ackerman in 1981 are an advance over those offered by him in 1976 and 1979, some of the criteria are flawed, such as diameter greater than 6 mm and shape of nests of melanocytes being described as irregular (no definition has been offered for "regular," let alone "irregular," in regard to outline of nests of melanocytes). Other modifications were to be added in the ensuing 20 years.