Histopathologic images from case 1, a pigmented lesion on the back of a 32yearold man. Junction nevus definition of junction nevus by medical. Histopathological diagnosis of small melanocytic lesions suspicious. Acquired melanoyctic naevus or mole is a common benign tumour, usually appearing during childhood and adolescence. The term benign melanocytic nevus refers to a heterogeneous group of nonmalignant melanocytic nevi manifesting either as pigmented or nonpigmented cutaneous lesions the prototypical benign melanocytic nevus is the common acquired nevus, which typically appears within the first 6 months of life, reaches maximal size and number in young. Junctional nevus with dysplastic features the epidermis is irregular with elongated rete ridges, hyperpigmentation, and diffuse melanocytic hyperplasia confined to the basal epidermis. Rete ridges are irregular and distorted with bridging b and eosinophilic fibrosis arrows. The junctional nevus is composed of discrete nests of melanocytesnevus cells at the dermoepidermal junction, usually located on the rete ridges, which often show some accentuation. Benign junctional melanocytic nevus general center. A junctional naevus is one in which clusters or nests of rounded or polygonal melanocytic cells are present at the dermalepidermal junction. I recently had a mole excised from the right side of my abdominal area. Conflicts of interest atypical melanocytic proliferations. A junctional nevus is a mole that is found in between the outermost layer epidermis and underlying layer dermis of skin.
The histological descriptions of aimp and sampus refer to melanocytic proliferations confined to the epidermis or epidermis and superficial dermis, respectively. Histopathology a compound nevus possesses features of both a junctional and an intradermal nevus. They are brown, round, flat spots macules that have regular borders. In melanocytic lesions studied in older individuals, the most common was the dermal nevus, 7, 8, 9 and with acquired nevi with a junctional component, there was a rapid dropoff in the presence of. The cells are oval to cuboidal in shape, with clear cytoplasm containing a. The nevus spilus or speckled lentiginous nevus is a lightly pigmented macular lesion ranging from less than 1 cm to greater than 20 cm in size that contains dark speckles fig. Atypical lentiginous junctional naevi of the elderly and. Maintaining a uniform and benign cytology,cells diminish in size as the base is approached. The name ancient is used because it shares numerous features with ancient schwannoma site. Associated with peutzjeghers syndrome, centrofacial lentiginosis, moynahans syndrome. A practical approach to the diagnosis of melanocytic lesions. Singh, et al neurotized congenital melanocytic nevus indian journal of dermatology 2015.
Common terms, including mole, birthmark, and beauty mark, are used to describe nevi, but these terms do not distinguish. We discuss salient clinical and pathologic features of blue nevi, with emphasis on the most diagnostically challeng. Some sources equate the term mole with melanocytic nevus, but there are also sources that equate the term mole with any nevus form. Mottled skin in the elderly is a result of extensive freckling, guttate hypomelanosis, solar lentigines, seborrhoeic keratoses and. Melanocytic nevus, junctional, he 40x 3525 junctional melanocytic nevus of the sole. The lesion may present as single or multiple round or oval shaped, tan brown, uniform central nevi which is surrounded by a amelanotic ring upto several milimeters in. A point mutation in the braf gene most often v600e is usually the initiating genetic mutation. Melanocytic lesions of the nail unit pubmed central pmc. Also called lentigo, lentigines often in acral sites precursor lesion to nevi, with proliferation of melanocytes but no nests in epidermal basal layer along rete ridges multiple lentigines. Definition of junctional nevus nci dictionary of cancer. Lesions evolve with age, the initial lesion being macular with nests. Melanocytic nevus, junctional, he 40x 2729 another case.
Large congenital nevus actually consists of small nodular benign melanocytes and these are not malignant changes. Junctional melanocytic nevus, he 40x 3510 another similar nevus of the same patient. The junctional nevus is composed of discrete nests of melanocytes nevus cells at the dermoepidermal junction, usually located on the rete ridges, which often show some accentuation. There was a slight female predominance, and the mean age of our patients was 40 years. Division of pathology and laboratory medicine, medical school. Scalp junctional nevus with malignant transformation melanoma metastatic to parotid lymph node region, cervical lymph nodes and the back. Embryology by 5 weeks of ga, epidermis differentiates into two layersthe basal layer or stratum germinativum and the overlying periderm by 10 weeks, an intervening layerthe stratum intermedium by 19 weeks, the intermediate cells, and the periderm begins to flatten by 23. Precursor lesion to nevi, with proliferation of melanocytes but no nests in epidermal basal layer along rete ridges multiple lentigines. Precursor lesion to nevi, with proliferation of melanocytes but no nests in.
Nevus cells cluster as nests within the lower epidermis andor dermis, whereas epidermal melanocytes are evenly dispersed as single units. Melanocytic nevus, junctional, he 40x 2307 another case. They are classified according to the location of the nevus cells in. Histopathological spectrum of benign melanocytic nevi our. The lentiginous nevus is a entity which appears to represent the evolution of a lentigo simplex into a junctional and sometimes a compound nevus. Halo nevus is a type melanocytic nevus which is usually noted in children and young adults. A compound nevus possesses features of both a junctional and an intradermal nevus. Nevus cells do not have dendritic processes, except for those within blue nevi. Note the junctional nests of spindle melanocytes and lack of sharp demarcation between nests of melanocytes and the epidermis inset. Usually, the type a nevus cells in the upper dermis are round to cuboidal and show. A practical approach to the diagnosis of melanocytic lesions nathan t. It is more correctly called a melanocytic naevus american spelling nevus and is sometimes also called a naevocytic naevus.
The distribution of the histopathologic types of this tumor in our population matches the pattern in other areas of the world with the compound nevus being the commonest lesion. The cells are oval to cuboidal in shape, with clear cytoplasm containing a variable amount of melanin pigment. No nevus cells found in surround connective tissue. However, some benign junctional melanocytic nevi may transform and become malignant malignant change of the skin is known as melanoma. Although the majority of these lesions can be confidently diagnosed using wellestablished morphologic criteria, there is a significant subset of lesions.
Soepronos textbook is available on and includes detailed information on over 600 entities and includes four dvd diskettes with highresolution images that provide a virtual dermatopathology reference and guide. Francisco bravo puccio and cesar chian 2011 acral junctional nevus versus acral lentiginous melanoma in situ. State of the art, nomenclature, and points of consensus. A melanocytic nevus also known as nevocytic nevus, nevuscell nevus and commonly as a mole is a type of melanocytic tumor that contains nevus cells. The compound variant of blue nevus can be distinguished histologically from combined blue nevus, pigmented spindle cell nevus, malignant melanoma, and melanosis due to a regressed malignant melanoma. Difficulties in the diagnosis of spitzoid melanocytic lesions. A symmetric and deeply pigmented junctional proliferation of melanocytes was found, with bandlike dermal melanophages. A mole is a common benign skin lesion due to a local proliferation of pigment cells melanocytes. Junctional nevus definition of junctional nevus by. Pigmented spindle cell nevus many dermatopathologists believe the pigmented spindle cell nevus pscn of reed, or reeds nevus, represents one end of the spectrum of spitz nevi, composed exclusively of spindled cells with the aforementioned spitzoid cytomorphology. Careful examination is required because similar type of focal proliferation of melanocytes junctional cavity occurs in melanoma. Nevus or nevi if multiple is a nonspecific medical term for a visible, circumscribed, chronic lesion of the skin or mucosa. Clinically, the lesions were dark brown to black macules or papules. It may be present at birth, but more commonly develops in childhood, with.
A clinical and histopathologic study of 14 cases atypical lentiginous nevus of the elderly is a peculiar form of dysplastic nevus. Because atypical lentiginous nevus manifests clinically as. Histopathologically, the nevus showed the following characteristics. Two uniformly brown small macules, round in shape with smooth regular borders. The matrix nevus is usually a junctional and only rarely a compound nevus. Our dermatology online brief report hhistopathological. Soeprono teaches and practices dermatopathology at loma linda university, school of medicine, department of dermatology. Melanocytic nevi and nonneoplastic hyperpigmentations. Melanocytic lesions are common in routine surgical pathology. Melanocytic lesions are commonly encountered in dermatopathology and an area which causes some difficulty, i. This image shows two junctional nevi that appear as uniformly brown small macules, round in.
A blue nevus can originate from the nail matrix, nail bed, or periungual deep dermis, and it can be cellular or common. Nevus cells in the upper, middle, and lower dermis may present characteristic morphologic variations called types a, b, and c, respectively. It has also been called nevoid lentigo and nevus incipiens. Irregular increase of the number of junctional melanocytes 02b junctional, compound and dermal nevi melanocytic nevus is a benign tumor, most often found during childhood or adolescence, which may develop on hair bearing skin or also on other sites including glabrous skin, nails or mucosae. Cockade nevi are pink to darkly pigmented lesions surrounded by an inner depigmented and outer pigmented rim characteristically visible on the scalp of children and adolescents fig. A differential diagnosis that should be based on clinicopathologic correlation. The commonest histopathological subtype was intradermal nevus comprising 73 % cases followed by compound nevus. They are wellcircumscribed, sometimes deeply pigmented, often quite small lesions, found most frequently on the trunk of adults between the. The compound nevus was the commonest 72% in all age groups, followed by subepithelial nevus 24% and finally junctional nevus 3%. Biopsy of mis with subsequent invasion in tumor debulk percentage of tumors with invasion cohen et al dermatol surg 1998 10 agarwalantal et al jaad 2002 16 zalla et al dermatol surg 2000 6. David weedon ao md frcpa fcaphon, in weedons skin pathology third edition, 2010. In this localization, the nevi can be junctional, compound, and dermal 1, 8.
Spitz tumor, also called spitz nevus or spindle and epithelioid cell nevus, is an uncommon melanocytic lesion that represents the benign or less aggressive end in a group of melanocytic neoplasms termed spitzoid melanocytic lesionsproliferations. Diagnosis, melanoma, nevi and melanomas, pathology. Histologically, it is not immediately clear whether a lesion is a subtle mis, a junctional nevus with atypical features, or benign melanocyte hyperplasia. Both melanocytes and nevus cells can produce the pigment melanin. A brown or black mole contains the pigment melanin, so may also be called a pigmented naevus. D pandhi et al, pigmentary disorders 2014, a l j journal.
Bridging of nests between adjacent ridges is present and. The diagnosis of atypical lentiginous melanocytic naevi in chronic sun. Atypical lentiginous nevus, originally defined as lentiginous dysplastic nevus of the elderly, was first described in 1991 by kossard et al. Pdf benign melanocytic lesions with emphasis on melanocytic. Neurotized congenital melanocytic nevus resembling a.
Pictures of skin diseases and problems junctional nevus. Lesions evolve with age, the initial lesion being macular with nests of proliferating. Histopathological diagnoses included atypical junctional nevus, atypical compound nevus. A junctional nevus is a mole that occurs between two layers of skin. It is characterized by the presence of nevus cell nests in the basilar region of epithelium. Compound melanocytic nevus with architectural disorder and shouldering s, or extension of the junctional component beyond the dermal nests of melanocytes d. The six lesions were from three men and three women whose ages ranged from 11 to 51 years mean, 31 years. Acral junctional nevus versus acral lentiginous melanoma. Blue nevi are often grouped together with hamartomatous dermal dendritic melanocytic proliferations such as nevus of ota, nevus of ito, and mongolian spot.
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