29. MELTUMP and SAMPUS

 
Quotation from the 9th edition of Lever's:
 
"This is a descriptive term for a heterogeneous group of melanocytic tumors that exhibit some features indicative of possible malignancy, such as nuclear atypia, macronucleoli, mitotic activity, necrosis, or ulceration, but in number or degree insufficient to justify a malignant diagnosis. Accordingly they reflect the biological reality that occasional melanocytic lesions that do not meet criteria for fully evolved melanoma cannot be predicted to be benign with 100% accuracy."
 
"Not all superficial melanocytic proliferations can reliably and reproducibly be distinguished as either a superficial melanoma or as a nevus. In such cases, we provide a descriptive designation, such as 'superficial atypical melanocytic proliferation of uncertain significance' ('SAMPUS'), with a differential diagnosis."
 
Reference in the 9th edition to concepts contrary by A. Bernard Ackerman et al. (ABA): None.
 
Statements contrary by ABA:
 
"Melanocytic tumor of uncertain malignant potential (MELTUMP). A phrase coined by David Elder and used by him, his co-workers, and followers of them for diagnosis of a "category" that "is comprised of melanocytic proliferations that form tumours in the dermis, and are therefore potentially capable of metastasis." For Elder et al., "Examples of such lesions may include atypical Spitz naevi, deep penetrating naevi, possible naevoid melanomas, or cellular blue naevi, where because of increased mitotic activity or cytologic atypia, a diagnosis of invasive or tumorigenic melanoma cannot be ruled out." Because MELTUMP is as unfathomable and as unuseful as SAMPUS (superficial atypical melanocytic proliferation of uncertain significance), another acronym spawned by Elder et al., it is best discarded now before a foothold is gained in the lexicon of general pathology and dermatopathology."
 
"Superficial atypical melanocytic proliferation of uncertain significance (SAMPUS). A phrase employed for diagnosis by David Elder, his associates, and followers of them to designate a "category" that "includes predominantly junctional melanocytic proliferations, and melanocytic proliferations that are confined to the epidermis and papillary dermis, without evidence of tumorigenic proliferation or mitotic activity there." Because the term is generic, rather than specific, it is not a diagnosis precise but a description recondite and, at the same time, an acknowledgment of doubt about behavior biologic, adding nothing to what should be an effort mighty to arrive at a diagnosis precise and to an understanding profound of melanocytic neoplasia. Now is the time to jettison the fuzzy phrase before it becomes yet another example of gobbledygook incorporated in the language of general pathology and dermatopathology."
 
Ackerman AB, Elish D, Shami S. "Spitz's nevus": Reassessment critical, revision radical. New York: Ardor Scribendi, 2005.