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c12t3P1: this is a higher magnification of the lesion seen in c11t3P7. There are ill-defined fascicular patterns in which cells are loosely spaced. Near the bottom of the field some of the cells are individually isolated in a fibrous matrix.
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c12t3P2: ill-defined fascicles are loosely spaced in a dense fibrous matrix. The matrix is interpreted as altered reticular dermis. Cells of the fascicles are loosely spaced. There is some degree of nuclear pleomorphism. There are minimal lymphoid infiltrates.
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c12t3P3: The epidermis is hyperplastic; rete ridges are elongated. A lentiginous component is spotty in distribution. Fascicles of deeply pigmented cells extend from the dermal-epidemal interface into a widened fibrotic papillary dermis. The loose spacing of the fascicles qualifies as a pattern of variant vertical growth.
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c12t3P4: cytologically, this is high grade melanoma. The cytologic features are “epithelioid.” Cells are loosely attached to their neighbors. Some of the nuclei have inclusions of cytoplasm.
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c12t3P5: the patterns are those of a pigmented spindle cell melanoma; some observers might find the features of malignant cellular blue nevus in these features. The cells form closely spaced, interlacing fascicles. Melanophages are a prominent feature.
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c12t3P6: cytologic grade is intermediate. The cells are heavily pigmented.
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c12t3P7: it is usually possible to find pigmented dendrites among tumor cells in a lesion of this type. In the area identified with blue arrows, dendrites are a prominent feature. Some of these lesions show features which might lead some observers to make comparisons with “epithelioid blue nevus.”
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c12t3P8: small, “epithelioid” cells form closely spaced nests; stroma is scanty. The cells are rounded or polygonal. Nuclear characteristics are uniform. Nuclear grade is intermediate.
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