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Agminated acquired melanocytic nevi of the common and dysplastic type.

Choi YJ, Kim HS, Lee JY, Kim HO, Park YM - Ann Dermatol (2013)

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

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Pigmented lesions that have been described as agminated includes melanocytic nevi, Spitz nevi, nevi spilus, blue nevi, and multiple lentigines... Herein, we describe a patient with multiple agminated acquired melanocytic nevi, several of that were histologically characterized as dysplastic nevi... No family history of melanoma or multiple moles was present... Physical examinations revealed more than 40 melanocytic nevi clustered in a 5×5 cm skin area on her right inguinal area, where several of these nevi were irregular with variegation of color and a diameter greater than 5 mm (Fig. 1A)... Therefore, clinical and histological classifications of nevi have the most important purpose of categorizing these lesions so that dysplastic nevi can be distinguished, clinically and histologically, from melanoma... One thing that deserves the attention of clinicians is that malignant melanoma developed within the lesions of both cases... There still exists much controversy about the presence of agminated ACDN... Marghoob et al. and Bragg et al. previously reported 5 cases of agminated ACDN... Unlike our case, however, agminated lesions were superimposed on an underlying dysplastic nevus syndrome phenotype in 4 out of 5 cases... In the 2 cases of the 5 reported as agminated ACDN, malignant melanoma did not developed within the agminated lesion, but within the underlying dysplastic nevus syndrome phenotype... The authors believed that agminated ACDN were a new, previously not described, clinical variant of dysplastic nevi... In conclusion, the uncertainty in the biological behaviors of agminated ACDN suggests a strict follow-up for this unusual entity.

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(A) There was elongation of rete ridges and increase in the number of junctional melanocytes, arranged in a nest. In the dermoepidermal junction, nests of nevus cells were profused on the tips and sides of elongated rete ridges. There were also scattered single cells in a lentiginous array without continuous proliferations. (B) Several melanocytes contained abnormally large nuclei, and the nuclei had irregular contours (arrows) (H&E; A: ×40, B: ×400).
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Figure 2: (A) There was elongation of rete ridges and increase in the number of junctional melanocytes, arranged in a nest. In the dermoepidermal junction, nests of nevus cells were profused on the tips and sides of elongated rete ridges. There were also scattered single cells in a lentiginous array without continuous proliferations. (B) Several melanocytes contained abnormally large nuclei, and the nuclei had irregular contours (arrows) (H&E; A: ×40, B: ×400).

Mentions: A 16-years-old female presented with multiple irregular moles on her right inguinal area (Fig. 1A). Her parents reported that this cluster of nevi developed at the age of 6 years, and continuously increased in numbers and sizes. No family history of melanoma or multiple moles was present. Physical examinations revealed more than 40 melanocytic nevi clustered in a 5×5 cm skin area on her right inguinal area, where several of these nevi were irregular with variegation of color and a diameter greater than 5 mm (Fig. 1A). No background pigmentation within or surrounding the cluster was noted clinically or even with Wood's light examination. Dermoscopy of the clustered nevi revealed a diffuse patchy reticulation (Fig. 1B). A biopsy from a clinically atypical nevus demonstrated a lentiginous, compound-melanocytic nevus with architectural disorder in the epidermis. In the dermoepidermal junction, the nests of nevus cells were profused in the tips and sides of elongated rete ridges. In the center of the nevus, nests of melanocytes are present in the papillary dermis (Fig. 2A). There were scattered single cells in a lentiginous array without continuous proliferations (Fig. 2A). A few atypical melanocytes with large, irregularly shaped, hyperchromatic nuclei lay individually or within a small group (Fig. 2B). The diagnosis of dysplastic nevi was confirmed by the presence of an architectural disorders and cytologic atypia. Several nevi within the cluster had clinical, dermoscopic, and histologic features which are commonly attributed to dysplastic nevi.


Agminated acquired melanocytic nevi of the common and dysplastic type.

Choi YJ, Kim HS, Lee JY, Kim HO, Park YM - Ann Dermatol (2013)

(A) There was elongation of rete ridges and increase in the number of junctional melanocytes, arranged in a nest. In the dermoepidermal junction, nests of nevus cells were profused on the tips and sides of elongated rete ridges. There were also scattered single cells in a lentiginous array without continuous proliferations. (B) Several melanocytes contained abnormally large nuclei, and the nuclei had irregular contours (arrows) (H&E; A: ×40, B: ×400).
© Copyright Policy - open-access
Related In: Results  -  Collection

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Show All Figures
getmorefigures.php?uid=PMC3756211&req=5

Figure 2: (A) There was elongation of rete ridges and increase in the number of junctional melanocytes, arranged in a nest. In the dermoepidermal junction, nests of nevus cells were profused on the tips and sides of elongated rete ridges. There were also scattered single cells in a lentiginous array without continuous proliferations. (B) Several melanocytes contained abnormally large nuclei, and the nuclei had irregular contours (arrows) (H&E; A: ×40, B: ×400).
Mentions: A 16-years-old female presented with multiple irregular moles on her right inguinal area (Fig. 1A). Her parents reported that this cluster of nevi developed at the age of 6 years, and continuously increased in numbers and sizes. No family history of melanoma or multiple moles was present. Physical examinations revealed more than 40 melanocytic nevi clustered in a 5×5 cm skin area on her right inguinal area, where several of these nevi were irregular with variegation of color and a diameter greater than 5 mm (Fig. 1A). No background pigmentation within or surrounding the cluster was noted clinically or even with Wood's light examination. Dermoscopy of the clustered nevi revealed a diffuse patchy reticulation (Fig. 1B). A biopsy from a clinically atypical nevus demonstrated a lentiginous, compound-melanocytic nevus with architectural disorder in the epidermis. In the dermoepidermal junction, the nests of nevus cells were profused in the tips and sides of elongated rete ridges. In the center of the nevus, nests of melanocytes are present in the papillary dermis (Fig. 2A). There were scattered single cells in a lentiginous array without continuous proliferations (Fig. 2A). A few atypical melanocytes with large, irregularly shaped, hyperchromatic nuclei lay individually or within a small group (Fig. 2B). The diagnosis of dysplastic nevi was confirmed by the presence of an architectural disorders and cytologic atypia. Several nevi within the cluster had clinical, dermoscopic, and histologic features which are commonly attributed to dysplastic nevi.

View Article: PubMed Central - PubMed

Affiliation: Department of Dermatology, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Pigmented lesions that have been described as agminated includes melanocytic nevi, Spitz nevi, nevi spilus, blue nevi, and multiple lentigines... Herein, we describe a patient with multiple agminated acquired melanocytic nevi, several of that were histologically characterized as dysplastic nevi... No family history of melanoma or multiple moles was present... Physical examinations revealed more than 40 melanocytic nevi clustered in a 5×5 cm skin area on her right inguinal area, where several of these nevi were irregular with variegation of color and a diameter greater than 5 mm (Fig. 1A)... Therefore, clinical and histological classifications of nevi have the most important purpose of categorizing these lesions so that dysplastic nevi can be distinguished, clinically and histologically, from melanoma... One thing that deserves the attention of clinicians is that malignant melanoma developed within the lesions of both cases... There still exists much controversy about the presence of agminated ACDN... Marghoob et al. and Bragg et al. previously reported 5 cases of agminated ACDN... Unlike our case, however, agminated lesions were superimposed on an underlying dysplastic nevus syndrome phenotype in 4 out of 5 cases... In the 2 cases of the 5 reported as agminated ACDN, malignant melanoma did not developed within the agminated lesion, but within the underlying dysplastic nevus syndrome phenotype... The authors believed that agminated ACDN were a new, previously not described, clinical variant of dysplastic nevi... In conclusion, the uncertainty in the biological behaviors of agminated ACDN suggests a strict follow-up for this unusual entity.

No MeSH data available.


Related in: MedlinePlus