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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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Mehregan
et al.
"Histological features in the early, or radial, phase [of melanoma] consist of extensive proliferation of large melanocytic cells with abundant and dusty cytoplasms [sic] at the dermoepidermal junction. There is a great tendency for junctional nest formation. Mitotic figures are present, and upward transmigration of small nests or individual atypical melanocytes within the epidermis is common. Extensive transepidermal elimination of large melanocytic cells is characteristic of the pagetoid variety. A lichenoid tissue reaction with basal cell damage associated with a lymphohistiocytic infiltrate is observed in the clinically white, regressive areas. The upper dermis shows fibroplasia, macrophages containing melanin, and patchy lymphocytic and plasma cell infiltrate . . ."
Mehregan A, Hashimoto K, Mehregan D, Mehregan D.
Pinkus' guide to dermatohistopathology.
6th Edition. Connecticut: Appleton and Lange, 1995:5023.
Brief Critique
Pagetoid melanocytes in pagetoid pattern within the epidermis is a sign of melanoma, but that finding is not come upon in most specimens of it. All of the other changes detailed are found in some Spitz's nevi.
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