GENERAL  INDEX

c23t3P1: Nuclear characteristics are fairly uniform. Blue arrows point to Kamino bodies. Cells are variably pigmented.

c23t3P2: Cytologic atypia is moderate to moderately severe. A red body in the epidermis on the right seems to be a necrotic keratinocyte, but might also be accepted as a variant Kamino body. Some of the cells have pigmented dendrites.

c23t3P3: In this field, at the advancing margin, there is evidence of “maturation.” To the right above, in the junctional component, the cytologic atypia is moderately severe.

c23t3P4: Upward migration of cells into the epidermis is a prominent feature.

c23t3P5: There is some degree of nuclear atypia. Focally, there is mild cellular pleomorphism.

c23t3p6: In this area in the reticular dermis, nests and fascicles of tumor cells are closely clustered in a typical vertical growth-like  pattern. This pattern would also qualify as migrant vertical growth-like; the nests to the right have entrapped a collagen bundle of the reticular dermis. The variable patterns, as well as the biologic significance of those patterns, are better served by  classifying the lesion as an intermediate neoplasm (i.e., juvenile melanoma or MDM of Spitz type) than as a “nevus.” In this  recommendation, the system of logic differs from that classically  associated with Spitz “nevus.” An acceptance of this altered logic, somewhat alters the original logic associated with the designation, juvenile  melanoma.

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