Dewan and Ackerman

 

"Our criteria for histopathologic diagnosis of melanoma are as follows:

 
Architectural Pattern
 
  1. Asymmetry
  2. Poor circumscription
  3. Nests of melanocytes within the epidermis not equidistant from one another
  4. Nests of melanocytes within the epidermis vary in size and shape
  5. Nests of melanocytes within the epidermis confluent in foci, the resultant aggregations thereby assuming peculiar geometric shapes sometimes
  6. Melanocytes within the epidermis disposed as solitary units predominate over nests of melanocytes in some high power fields
  7. Solitary melanocytes within the epidermis not equidistant from one another
  8. Scatter of melanocytes, both those disposed as solitary units and those in nests, above the dermoepidermal junction
  9. Uneven distribution of melanin within the epidermis
  10. Involvement of epithelial structures of adnexa by melanocytes in the same manner as within the epidermis
  11. Nests of melanocytes within the dermis vary in size and shape
  12. Nests of melanocytes within the dermis confluent in foci; formation sometimes of aggregations with peculiar geometric shapes and/or sheets of neoplastic cells
  13. Failure of maturation of melanocytes with progressive descent into the dermis
  14. Base of neoplasm uneven
  15. Uneven distribution of melanin within the dermis
 
Cytopathologic Features
 
  1. Pleomorphism of nuclei of melanocytes
  2. Mitosis, some of them sometimes abnormal, of melanocytes
  3. Necrosis of melanocyte sometimes
 
Of the 15 criteria for histopathologic diagnosis of melanoma that pertain to architectural pattern, the first 10 apply only to epidermal and adnexal epithelium, whereas the last five pertain only to the dermis. In short, the first 10 criteria define melanoma in situ, i.e., melanoma confined to epidermal and adnexal epithelium." Dewan M, Ackerman AB. What is your diagnosis of these melanocytic neoplasms? Dermatopathol: Pract and Conc 1999; 5(4):334.
 

Brief Critique

 
A reader is encouraged to compare and contrast these criteria (1999) with those of Becker and Obermayer (1947), Ormsby and Montgomery (1948), and Lever (1949).