DERMATOPATHOLOGY CASES: Self-Assessment Cases: Editor - Dr Sampurna Roy MD

Digital Images of interesting cases that will include the full spectrum of Dermatopathology, presented in the form of quiz.

The answer of the cases include related links and recent abstracts of articles.

Monday, January 23, 2012

Answer of Dermatopathology Case 114

Deep Penetrating Nevus

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Deep penetrating nevus: a review.Arch Pathol Lab Med. 2011 Mar;135(3):321-6.
Deep penetrating nevus is a distinctive melanocytic lesion that may simulate melanoma both clinically and histologically.
To review clinical and histologic features of deep penetrating nevi and discuss their differential diagnosis, especially regarding melanoma.
The literature on deep penetrating nevi is reviewed and supplemented by our experiences with deep penetrating nevi.
One or more disturbing histologic features may frequently be found in deep penetrating nevi, including asymmetry, plump but fairly regular nests of melanocytes in the dermis, cytologic atypia with some nuclear pleomorphism, a small to medium-sized eosinophilic nucleolus, absence of maturation, occasional presence of normal dermal mitoses, and a patchy mononuclear inflammatory cell infiltrate. Although unusual, such histologic features should not be regarded as a sign of malignancy in deep penetrating nevi.

Pigmented lesion pathology: what you should expect from your pathologist, and what your pathologist should expect from you.Clin Plast Surg. 2010 Jan;37(1):1-20.
The first part of this review examines the reliability of histologic diagnosis in pigmented lesions, as measured by concordance studies and medicolegal analysis. It emphasizes the role of clinicians in maximizing that reliability, by providing adequate clinical descriptions, using appropriate biopsy technique, and critically interpreting pathology reports. It identifies those entities that are especially problematic, either because they cannot be reliably recognized by the histopathologist or because their histology is a poor guide to their biologic behavior. The second part of the review is a guide to some of the more difficult and controversial pigmented lesions, including dysplastic nevus, spitzoid nevi and melanomas, cellular blue nevus, animal-type melanoma, and deep penetrating nevus.