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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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Maize
et al.
"The earliest lesions of most melanomas
in situ,
small macules clinically, appear microscopically as proliferations of solitary melanocytes at or slightly above the dermoepidermal junction, spaced at irregular intervals. The nuclei of melanocytes in these early neoplasms may or may not be cytologically atypical, but are almost always larger than those of the non-neoplastic basilar melanocytes. As lesions of melanoma
in situ
evolve, melanocytes can aggregate to form nests and spread to the upper spinous, granular, and cornified layers. Often, single neoplastic melanocytes will be visible beyond the last nest on either side of the lesion, and some of these cells may be situated above the basal layer. Melanoma
in situ
typically involves follicular infundibula and acrotrychia [sic] in a given lesion with melanocytes distributed in the same pattern as they are within the interadnexal epidermis."
Maize JC
et al. Cutaneous pathology.
Philadelphia: Churchill Livingstone, 1998:689.
Brief Critique
Most of the criteria presented here were forged in conjunction with Ackerman, who, in 1987, together with Maize, did a book titled "Pigmented Lesions of the Skin."*
*Maize J, Ackerman AB.
Pigmented lesions of the skin.
Philadelphia: Lea & Febiger
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