Skin - Melanocytic tumor
Melanoma - Features to report

Author: Christopher Hale, M.D. (see Authors page)

Revised: 7 December 2018, last major update May 2013

Copyright: (c) 2002-2018,, Inc.

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Cite this page: Hale C Features to report. website. Accessed January 23rd, 2019.
Features to Report
  • Specimen type / procedure
    • If biopsy, specify shave, punch or incisional; excision or reexcision
    • If lymphadenectomy, specify if sentinel node(s) or regional nodes
  • Tumor location
  • Histologic subtype
  • Margin of excision (distance from tumor) - lateral and deep
  • Angiolymphatic invasion (if present)

Mandatory features used for pathologic staging:
  • Maximum tumor thickness (Breslow)
  • Tumor ulceration
  • Laterality
  • Tumor size
  • Macroscopic satellite nodule(s) (required for excision specimens only)
  • Macroscopic pigmentation
  • Histologic type
  • Anatomic level:
    1. (melanoma in situ)
    2. (melanoma present in, but does not fill and expand, papillary dermis)
    3. (melanoma fills and expands papillary dermis)
    4. (melanoma invades reticular dermis)
    5. (melanoma invades subcutaneum)
  • Ulceration

Features used in some protocols for treatment choice:
  • Tumor depth (Clark levels)
  • Margin of excision (distance from tumor) - lateral and deep
  • Mitotic index: less or greater than 1/mm²
  • Microsatellitosis
  • Lymph vascular invasion
  • Perineural invasion
  • Tumor infiltrating lymphocytes
  • Tumor regression
  • Growth phase: radial, vertical or indeterminate

Lymph nodes:
  • Number of nodes examined, number with melanoma (if available)
  • Extranodal tumor extension

Additional features:
  • Tumor size
  • Tumor mitotic rate
  • Regression
  • Precursor lesion
  • Host lymphocytic response (absent, present nonbrisk, brisk)
  • Mitotic index (reported per mm²)
  • Characteristics of radial growth phase and vertical growth phase
  • Pathologic staging (pTNM, J Clin Oncol 2009;27:6199)
  • Nevus remnant
Diagrams / tables

Images hosted on other servers:

Brisk tumor-infiltrating lymphocytes