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c21t3P1: The patterns in the epidermis and at the dermal-epidermal interface are those of a senescent lichenoid reaction. There are mild spotty lichenoid patterns at the dermal-epidermal interface. At the interface between the papillary dermis and the reticular dermis, there are clusters of heavily pigmented melanophages. The reticular shows solar elastosis. This is a classic pattern in the site of a regressed melanoma. In my experience, regression in a halo nevus is not as likely to produce this degree of melanoderma.
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c21t3P2; At higher magnification, the pigmented cells have bland nuclear characteristics; they are melanophages. There are minimal infiltrates of lymphoid cells.
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c21t3P3: Spindle cell dysplasias share some features with Spitz nevus-like variants; the common features include the spindle cells, and the tendency for spindle cells to form fascicles. The dense chromatin patterns differ from those of classic Spitz nevus. In any case, the fascicles centrally are loosely but regularly spaced to form a small nodule. This pattern is acceptable as arrested variant vertical growth, if the basic lesion is acceptable as a premalignant dysplasia. If assigned to the Spitz category, there is likely to be considerable hemming and hawing about the nature of the lesion. If accepted as a spindle cell variant of common premalignant dysplasia, then the central pattern would qualify the lesion as a MDM arising in a premalignant dysplasia. The lesion would measure less than 1 mm in vertical dimensions; it would qualify as a borderline melanocytic neoplasm of indeterminate malignant potential.
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c21t3P4: At higher magnification, the degree of atypia is moderate to moderately severe. The pattern is level III.
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c21t3P5: This the classic pattern of the common final pathway. It is the pattern of radial growth that characterizes SSM. Depending on whims, the lesion in this field is severe or marked dysplasia (and borderline), or melanoma in situ (and borderline). To the right, the pattern is one of partial regression, and has lichenoid qualities.
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c21t3P6: In another field of the same lesion as c14t3P5, the spacing of nests of atypical cells in the widened papillary dermis qualifies as thin (minimal), typical and variant vertical growth at level III. On the basis of physical dimensions of the small vertical growth component (less than 1 mm in vertical dimensions), the lesion is a MDM SSM. it additionally qualifies as borderline melanocytic neoplasia of indeterminate malignant potential.
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c21t3P7: The pattern of typical vertical growth is manifested just to the right of the center of the field. Degree of atypia is marked.
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c21t3P8: In this nodal metastasis, the cytologic features are somewhat different from the pattern in the primary lesion..
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c16t3P9: In this thin, borderline melanoma, the degree of dysplasia is marked with some degree of polymorphism. The lesion was borderline on the basis of vertical dimensions less than 1 mm.
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