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c8t3P1: “epithelioid” cells are arranged in nests and fascicles in a delicate, fibrous matrix. In the nests and fascicles, the cells are loosely attached to their neighbors; the patterns have a pseudo-tubular quality. Some of the cells are pigmented; melanophages are present among the nests and fascicles. Inflammation is not a feature. There is some degree of nuclear pleomorphism. I suspect some observers might characterize the lesion as having “spitzoid” qualities. The cavitation of nests of cells is a feature commonly seen in common nevi.
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c8t3P2: this is another example in which uniform, atypical spindle cells are arranged in loosely spaced, broad fascicles (intermediate stage of neoplasia - beyond minimal deviation stage). The matrix is fibrous and fairly abundant. Inflammation is not a feature.
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c8t3P3: the neoplastic cells have scanty, pale cytoplasm with fine dendritic processes. They are loosely attached to their neighbors. Nuclei are variable in outline. Nuclear membranes are “heavy.” Many nuclei have central nucleoli.
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c8t3P4: the nests and fascicles are closely aggregated. The cells are spindle shaped, or polygonal in outline. Cells are loosely attached to their neighbors. The cells have plump, hyperchromatic nuclei.
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c8t3P5: fascicles of spindle cells are loosely spaced in a fibrous matrix. The interfaces between fascicles and stroma are ill-defined. The atypical cells have elongated, hyperchromatic nuclei with dense chromatin. There is one multinucleated giant cell. Neoplastic cells are loosely attached to their neighbors.
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c8t3P6: although fascicles are represented, the patterns are ill-defined. Focally, patterns have a diffuse quality. There is pleomorphism with scattered tumor giant cells. There are loose, interstitial infiltrates of lymphoid cells. The lesion qualifies as a pleomorphic melanoma; the lesion might be mistaken for a fibro-histiocytic neoplasm or an atypical fibroxanthoma.
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