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Plantar surface
Erosive and macerated lesion
In situ
Invasive ALM
Contributed by Carlos A. Torres-Cabala, M.D.
Atypical compound melanocytic proliferation
Atypical junctional component
Vertical growth phase
Atypical melanocytes
Pagetoid spread
Atypical epithelioid melanocytes
Confluence of atypical junctional melanocytes
Epithelioid to spindled cytology
SOX10
D2-40 / MITF double stain
HMB45
MelanA
SOX10 in invasive component
PRAME
Contributed by Lucia Lospalluti, M.D.
Small and dark brown lesion
Pigmented acral lesion
Pigmented acral nevus on a foot
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Various patterns
Transition pattern
Contributed by Gerardo Cazzato, M.D. and Angel Fernandez-Flores, M.D., Ph.D.
Poor circumscription
Nests of melanocytes
Pigmented nests of melanocytes
Acral nevus
Melanocytes of acral nevus
Pseudo dysplastic melanocytes
Contributed by Sepideh Nikki Asadbeigi, M.D. and AFIP
ALK fusion
Infiltrative border
Atypical cytomorphology
Bulbous infiltrating base
Epidermal hyperplasia
Lack of maturation in deep portion
Large epithelioid
cells with
amphophilic
cytoplasm
Common histological features associated with Spitz nevus
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Flesh colored papule
Right dorsal third toe
Red-brown papule
Red-orange nodule
Erythematous pedunculated papule
Contributed by Matthew J. Kuhar, M.D., Ahmed K. Alomari, M.D. and Carina Dehner, M.D., Ph.D.
Combined nevus
Epithelioid cell morphology
Distinct cell borders
Well circumscribed nodule
Atypical epithelioid melanocytes
Lymphocytic infiltrate
Negative BAP1 IHC staining
BAPoma - BAP1 inactivated nevus / melanocytoma - mimic of nevoid melanoma
Contributed by Mark R. Wick, M.D.
Cellular blue nevus
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Giant cellular blue nevus
Contributed by Carlos A. Torres-Cabala, M.D.
Common blue nevus
Dendritic melanocytes and melanophages
Focal extension into subcutis
Dense collagen stroma
Pigmented dendritic melanocytes
Pigmented melanophages
Cellular blue nevus
Dermal spindle cells
Biphasic appearance
Biphenotypic cytology
Sharp demarcation between the 2 populations
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Various images
Various images
Axillary freckling
Lesion of face
Neurofibromatosis type I patient
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Globular pattern
associated with a
central homogenous
pattern (darker area)
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Spitz nevus and common nevus
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Multiple 3 - 4 mm junctional nevi
Junctional melanocytic nevus
Compound melanocytic nevus
Contributed by Jeffrey McBride, M.D.
Benign intradermal nevus
Benign nevomelanocytes
Maturation
Multinucleated melanocytes
Microscopic description of junctional, compound and intradermal melanocytic nevi
Microscopic differences between solar lentigines and junctional nevi
Comprehensive clinical and histopathologic review of benign pigmented and melanocytic lesions including common acquired nevi
Microscopic clues to the diagnosis of melanoma versus benign nevi
Contributed by Mark R. Wick, M.D.
Breast skin
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10 year old girl
Dermoscopically typified by a globular pattern
Papillomatous surface
Verrucous surface and hair
Giant CMN covering 20% of the total body surface area
Newborn with giant hairy congenital nevus
Ulcerated nodule within scalp
Reticular pattern and regular globules
Globular pattern and patchy network
Haloed globules
Target network and target globules
Contributed by Anila Chughtai, M.B.B.S.
Dermal melanocytic proliferation
Grenz zone
Melanocytes dissecting collagen bands
Melanocytes centered on pilosebaceous units
Melanocytes involve arrector pili muscle
Melanocytes centered on eccrine duct
Variable pigmentation
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MRI of the brain
CT showing a scalp lesion
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Gray-blue scalp lesion
Dark brown scalp lesion with ulceration
Erythematous tan-brown papules and plaque on scalp
Cerebriform swelling with alopecia / bluish firm nodules
Bluish, ill defined lesion on the scalp
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Tan-white to yellow smooth cut surfaces
Contributed by Muhammad Tahir, M.D, M.S. and Thuy L. Phung, M.D., Ph.D.
Well circumscribed, dermal based lesion
Epithelioid / spindled cells
Mild cytologic atypia
Lymph node metastasis
S100
Dual stain: MelanA and Ki67
MITF
SOX10
p63
AE1 / AE3
CK5/6
EMS
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Forearm lesion
Dermoscopy
Mandible leasion
Contributed by Gregory A. Hosler, M.D., Ph.D.
Pure type
Atypia, pure type
Mixed type
Lymphoid aggregates
Neurotropism
Mitosis
S100
SOX10
Spindle cell melanoma
Desmoplastic melanoma: 5 minute pathology pearls
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Dysplastic,
pointillist
nevi with multiple
brown dots
Diffuse and patchy network pattern
Agminated atypical nevi
Agminated atypical nevi on right arm
Multiple melanocytic nevi (anterior chest and abdomen)
Dysplastic nevus syndrome
Minimal change in a clinically dysplastic nevus
Evolving and regressing clinical dysplastic nevus
Development of a clinically dysplastic nevus
Contributed by Sepideh Nikki Asadbeigi, M.D., Aleodar Andea, M.D. and AFIP images
Focally severe atypia
Dermal - epidermal junctional nest bridging
Enlarged nevomelanocytes and dusty cytoplasm
Shouldering
Cytological atypia
Bridging and focal lentiginous spread of melanocytes
Bridging
Clark nevus
Dysplastic nevus by Dr. Jerad Gardner
Compound Clark nevus
Dr. Clay Cockerell's approach to dysplastic nevi
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Face
Face and upper body
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Normal mole and halo nevus
Depigmentation around nevi on back
Contributed by Angel Fernandez-Flores, M.D., Ph.D.
Various images
CD3 (T cells)
CD20 (B cells)
Melan A
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Early regression
CD8+ T cells
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AJCC staging 8th edition
Contributed by Michele Donati, M.D.
Superficial spreading melanoma
Nodular melanoma
Invasive acral lentiginous melanoma
Lentigo maligna melanoma
Desmoplastic melanoma
Achromic melanoma
Ugly duckling sign
Hutchinson sign
Blowfly sign
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Thickened plaques on the nipple
Superficial spreading melanoma
Melanoma in situ
Melanoma in situ: acral lesion with parallel ridge pattern (B)
Melanoma in situ: before and after Imiquimod cream (A, B)
Melanoma in situ
Contributed by Michele Donati, M.D.
Superficial spreading melanoma
Invasive acral lentiginous melanoma
Contributed by Michele Donati, M.D.
Asymmetry
Early vertical growth phase
Poorly differentiated melanoma
Nodular melanoma
Confluent nests
Ulceration
Superficial spreading melanoma in situ
Epidermal consumption
Invasive superficial spreading melanoma
Ill defined border
Pagetoid spread
Lentigo maligna melanoma
Atypical melanocytes
Hair follicle involvement
Acral lentiginous melanoma, vertical growth phase
Acral lentiginous melanoma
Desmoplastic melanoma
Perineural invasion in DM
MelanA
S100
Contributed by Jijgee Munkhdelger, M.D., Ph.D. and Andrey Bychkov, M.D., Ph.D.
Dermal nodule with prominent pigmentation
Nodular melanoma
Loss of rete ridges
Cutaneous melanoma, HMB45
Metastatic melanoma
Lymph node metastatic melanoma
Contributed anonymously
Regression in melanoma
Tumor infiltrating lymphocytes
Subcapsular lymph node metastasis
Lymphatic invasion
Spindle cell melanoma with mitotic figures
Contributed by Angel Fernandez-Flores, M.D., Ph.D.
Pagetoid extension
Follicular growth
Contributed by Epitomics
PMEL17
Contributed by Michele Donati, M.D.
May Grünwald Giemsa smear preparation
Contributed by Petr Šteiner, Ph.D.
MYC amplification
CDKN2A loss
Melanoma
Superficial spreading melanoma
Acral lentiginous melanoma
Desmoplastic melanoma
Immunohistochemistry
Melanoma in situ
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Back lesions
Pre and post laser treatment
Contributed by Julia Nunley, M.D.
Lentigo maligna involving forearm
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Asymmetric
and irregularly
pigmented
macule
Contributed by Joseph Gillam, M.D., Jennifer Crimmins, M.D. and Mark Mochel, M.D.
Broad intraepidermal proliferation of melanocytes
Crowded, atypical intraepidermal melanocytes
Atypical intraepidermal melanocytes
Broad compound proliferation of melanocytes
Dermal nests with fibrosis
SOX10 highlighting pagetoid growth
Contributed by Shyam Raghavan, M.D.
Atypical melanocytic proliferation
Spindle and epithelioid melanocytes
Irregular nests
Mitotic figures
Spitz nevi and spitzoid melanocytic lesions
Contributed by Anila Chughtai, M.B.B.S.
Nodular ulcerated mass in CMN
Multiple congenital melanocytic nevi
After excision of malignant growth
Contributed by Anila Chughtai, M.B.B.S.
Dermal based proliferation of atypical melanocytes
Architectural arrangement of melanoma
Architectural arrangement of background nevus
Background nevus cell around sebaceous units
Cellular features of melanoma cells
Cellular features of melanoma cells
Brisk mitotic activity
Tumor necrosis
Variable pigmentation
Epidermal consumption
Tumor infiltrating lymphocytes
Nonbrisk tumor infiltrating lymphocytes
Brisk tumor infiltrating lymphocytes
Melanoma metastasis to lymph node
S100 stain
HMB45 stain
MelanA stain
Contributed by Anila Chughtai, M.B.B.S.
Diff-Quik stained smear
Papanicolaou stained smear
Cytoplasmic melanin pigment
Cytoplasmic melanin pigment
Cell block preparation
HMB45 stain on cell block
MelanA stain on cell block
Melanocytic dermpath basics: melanoma
Contributed by Gerardo Cazzato, M.D., Ph.D.
Melanocytes with clear / balloon cytoplasm
Balloon cell with atypia
Rhabdoid melanocytes within necrosis
Rhabdoid melanocytes with mitoses
Striking atypical melanocytic proliferation
Melanoma with pseudo-epitheliomatous hyperplasia
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Signet ring cell melanoma
Small cell melanoma
Myxoid melanoma
Rhabdoid melanoma
Small cell melanoma
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Diseases and syndromic associations
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Labial melanotic macule
Congenital melanotic macules of the tongue
Labial melanotic macule in LHS
Dermoscopy in LHS
Contributed by Khaled Sabry Mohamed, M.D. and Priya Nagarajan, M.D., Ph.D.
Volar skin melanotic macule
Mucosal melanotic macule
Vulvar melanotic macule
Mucosal melanotic macule
Labial melanotic macule
(brown spot on lip)
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Visceral organ masses
Pleural mass with effusion
Axial CT enhancing lesions
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Melanoma in transit metastases
Satellite metastasis melanoma
Contributed by Alison Potter, M.B.B.S.
Numerous cutaneous melanoma deposits
Contributed by Alison Potter, M.B.B.S.
Intracranial metastasis, peritheliomatous pattern
Small bowel submucosal deposit
Splenic metastasis
Gallbladder polyp
Cutaneous metastasis
Epidermotropism in cutaneous metastasis
Lymph node metastasis, pigmented melanoma
Metastatic melanoma and tumoral melanosis
In transit metastasis within skin
In transit metastasis in lymphatics
Dedifferentiated melanoma axilla
Dedifferentiated component
Conventional melanoma transition to dedifferentiated
Dedifferentiated melanoma with SOX10
Dedifferentiated melanoma with HMB45
Dedifferentiated melanoma with MelanA
Dedifferentiated melanoma with BRAF V600E
Contributed by Alison Potter, M.B.B.S.
Hilar mass metastatic melanoma
Singly dispersed melanoma cells
Melanophages within melanoma
Pseudopapillary clusters on Pap stain
Pap stained melanoma and melanophages
Tumor aggregates in cell block
MelanA positive tumor
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Malignant oral melanoma
Vaginal melanoma lesion
Malignant melanoma of the minor labia
Contributed by Mona Deerwester, M.D. and Janira M. Navarro Sanchez, M.D.
Invasive mucosal melanoma
Melanoma in situ of the vulva
Malignant melanoma of the vulva
Malignant melanoma of the vagina
S100 stain
Contributed by Mona Deerwester, M.D.
Multinucleated cells
Discohesive cells
Multinucleated cells and melanophages
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Morphologic features of melanoma
Cytologic immunohistochemical stains of melanoma
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Melanoma cells
with melanosomes
and premelanosomes
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Various images
Lesion #2:
Various images
Lesion #3:
Various images
Atypical single cells
Mitotic figures
Contributed by Robert E. LeBlanc, M.D.
Nodal nevus
Nodal metastasis
Regression
Microsatellite
Breslow depth
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Red, friable, broad based nodule
Ulcer on left middle finger
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Tumor cells are isolated or in nests
Tumor cells are MelanA+
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Irregularly pigmented plaques
Dermoscopy
Contributed by Bethany R. Rohr, M.D.
Epithelioid melanocytes
Pagetoid melanocytes
Poorly nested melanocytes
Atypical melanocytes
SOX10 immunostain
HMB45 immunostain
Superficial spreading melanoma
by Dr. Jerad Gardner
Contributed by Jonathan D. Ho, M.B.B.S., D.Sc.
Dermal nevus
Melanoma, high cumulative sun damage (CSD)
Spitz melanocytoma
Metastatic melanoma
Blue nevus
Melanoma cytomorphology
Acral lentiginous melanoma
Acral lentiginous melanoma in situ
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Linear distribution of nevi behind ear
Contributed by Kaitlin Vanderbeck, M.D. and Carlos A. Torres-Cabala, M.D.
Pigmented
predominantly
dermal melanocytic
lesion
Pigmented epithelioid to spindled melanocytes
Combined nevus
HMB45
Ki67
Beta catenin
Beta catenin nuclear positivity
Cyclin D1
LEF1
Bhawan: 2022
Bolognia: 2017
Brenn: 2017
Busam: 2018
Calonje: 2019
Dadzie: 2016
Elder: 2022
Elder: 2020
Elston: 2018
Gardner: 2019
Gru: 2023
IARC: 2018
Johnston: 2023
Massi: 2013
Plaza: 2016
Rapini: 2021
Find related Pathology books: dermatopathology, hematopathology, IHC
