Ways to get into trouble, ideas on avoiding trouble, and diagnostic approaches to keep trouble at bay

Size: px
Start display at page:

Download "Ways to get into trouble, ideas on avoiding trouble, and diagnostic approaches to keep trouble at bay"

Transcription

1 Pitfalls in the diagnosis of melanocytic tumors Timothy McCalmont, MD University of California, San Francisco Ways to get into trouble, ideas on avoiding trouble, and diagnostic approaches to keep trouble at bay Melanoma or not? Melanocytic nevus or not? Common and routine determination made by histopathologists Reasonably accurate (we trust!), much of the time An incorrect judgment holds implications for both patient and physician 1

2 Risks of an incorrect judgment (a misdiagnosis) Undertreatment Overtreatment Embarrassment Legal culpability All of the above The mindset: There are many ways to get into trouble in the interpretation of melanocytic tumors We can t talk about all of them, at least not today The best means to stay out of trouble is to avoid it in the first place Stephen Jay Gould The world contains far more objects and subtleties than we have concepts, so we make mistakes all the time 2

3 Wallace Clark A pathology specimen represents little bits of a fellow human being; the pathologist will be bonded to that person for a lifetime and should never underestimate that bond Wallace Clark Do not ever make the diagnosis of melanoma quickly, casually, or without vigilant forethought of the consequences; for the recipient, a life is changed forever Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism 3

4 Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism 4

5 5

6 6

7 Dodging the pitfall Poor sectioning may obscure key findings, so don t accept that Pale staining may hide cellular and tissue details, so don t accept that Poor fixation or use of non-formalin fixatives may impede interpretation (including molecular evaluation) Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism 7

8 8

9 9

10 2 years later 10

11 11

12 12

13 Dodging the pitfall Maintain a system to be certain all unique tissue sections on a slide have been reviewed Work at a comfortable pace Know your limits and don t exceed them Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism 13

14 14

15 Underdiagnosis of a nonpagetoid or subtle pagetoid pattern 15

16 16

17 17

18 18

19 19

20 20

21 21

22 22

23 Overdiagnosis of a prominent pagetoid configuration Kiddo with a diagnosis of melanoma on the foot Parent-initiated second opinion 23

24 24

25 25

26 Ultimate diagnosis: Pagetoid pigmented spindle cell (Reed/Spitz) nevus Pagetoid melanocytic nevi Pagetoid Spitz nevus Pagetoid Reed nevus Acral melanocytic nevus Irritated melanocytic nevi Superficial spreading Spitz nevus Superficial spreading Spitz nevi 26

27 27

28 28

29 29

30 SSSN N = 41; M:F = 12:29 Mean age 35.7 years (3-80) Leg: 68% Lateral spread: 2.1 +/- 0.8 mm Pagetoid scatter: 85%; marked 32% Desmoplasia: 36% Dodging the pitfall Nested configurations of melanoma are not uncommon: a pagetoid configuration is not required Watch for big nests ( meganests ) Variants of melanocytic nevi with a pagetoid configuration are common: all that is pagetoid is not melanoma 30

31 Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism Adolescent male: Clinical diagnosis:? Spitz Pathologic diagnosis: STUMP or spitzoid melanoma with recommendation for SLNB 31

32 32

33 33

34 34

35 HRAS-mutated Spitz nevus 11p Spitz (HRAS-mutated) van Engen-van Grunsven AC et al. HRAS-mutated Spitz tumors: A subtype of Spitz tumors with distinct features. Am J Surg Pathol Oct;34(10): Bastian BC, LeBoit PE, Pinkel D. Mutations and copy number increase of HRAS in Spitz nevi with distinctive histopathological features. Am J Pathol Sep;157(3): McCalmont TH, Vemula S, Sands P, Bastian BC. Molecularmicroscopical correlation in dermatopathology. J Cutan Pathol Apr;38(4): p Spitz (HRAS-mutated) Often large with desmoplasia Horizontal orientation, often Infiltrative, commonly Melanocytes in mitosis, often In young adults rather than young children, often 35

36 The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) 36

37 37

38 38

39 The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) 39

40 The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) 40

41 The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) 41

42 42

43 ALK p16 43

44 44

45 45

46 p16 NTRK1 46

47 Kinase fusion Spitz Induced by various kinase gene fusions, including ALK, NTRK1, NTRK3, ROS1 Partially transformed tumors that may be large with mitotic figures p16 immunohistochem of value in screening for potential second hit The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) 47

48 48

49 BAP1 p16 BAP-1 and BAPoma BRCA-associated protein 1 Tumor suppressor protein Key element in ocular melanoma Weak role in cutaneous melanoma BAPomas are partially transformed May be marker for syndromic BAP- 1 mutation 49

50 The full Spitz spectrum Conventional Spitz Superficial spreading Spitz HRAS-mutant Spitz Gene fusion Spitz (ALKoma and NTRKoma BAPoma (epithelioid with BAP-1 genomic loss) Atypical Spitz / spitzoid melanoma 50

51 p16 Dodging the pitfall Recognize that there has been an explosion of understanding in the Spitz spectrum Nomenclature is in flux Mitotically-active, partially transformed tumors can potentially be overcalled as melanoma 51

52 Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism Desmoplastic melanoma M > F (13:10) Mean onset: >60 years Head or neck area: 70% Pigmentation: 25-30% Visceral > Nodal: (2:1) 52

53 53

54 S100 54

55 Melan-A Desmo MM IHC S100 / SOX10: highly effective HMB, Mel-A, MART: ineffective p75: effective but unavailable WT-1: cytoplasmic, effective CD34: tends to be absent (often present in neurofibroma) 70 year old VA patient with diagnosis of spindle cell carcinoma by conventional microscopy 55

56 56

57 57

58 58

59 Everything desmoplastic is not desmoplastic melanoma Desmoplastic carcinoma Desmoplastic AFX Desmoplastic nevus Desmoplastic Spitz nevus Nevus with hybrid nerve sheath differentiation 59

60 60

61 61

62 Melan-A Melan-A CD34 62

63 Dodging the pitfall Liberally utilize SOX10 or S100 in the evaluation of spindle cell tumors, especially if with elastosis Eschew Melan-A, MART1, HMB45 Remember desmoplastic nevi If you encounter desmo MM arising with a nevus, it s probably not that Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism Young woman new in clinic Reportedly with melanoma of 2 mm in thickness Diagnosis with concurrence by 2 pathologists Wide local excision, sentinel nodes already done and all negative 63

64 64

65 65

66 Ultimate diagnosis: combined melanocytic nevus Inverted type A nevus Focal clonal hyperplasia or clonal nevus (Deep penetrating nevus centrally in a congenital melanocytic nevus) 66

67 Ultimate diagnosis: combined melanocytic nevus Inverted type A nevus Focal clonal hyperplasia or clonal nevus (Deep penetrating nevus centrally in a congenital melanocytic nevus) The component of DPN is triggered by an activating beta catenin mutation 35 year old male Recently changing pigmented lesion of the arm Diagnosis of melanoma of 1 mm in thickness at an academic dermatopathology laboratory Patient-initiated second opinion 67

68 68

69 69

70 Ultimate diagnosis, again: combined melanocytic nevus Combined melanocytic nevi Conventional and blue Conventional and Spitz Blue and Spitz Dysplastic and Spitz Conventional and BAPoma Et cetera 70

71 71

72 72

73 Dodging the pitfall When encountering two populations, consider combined nevus as well as melanoma ex nevus Most melanoma initiates along the junction; be cautious in the diagnosis of wholly dermal melanoma ex melanocytic nevus Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism 73

74 22 year old, from Phoenix, with new pigmented lesion 74

75 75

76 76

77 Called a Spitz and nothing more done No comment regarding: unconventional features mitotic figures status of the margin need for consideration of reexcision 77

78 78

79 79

80 Called a persistent Spitz and nothing more done 80

81 About 2 years later 81

82 82

83 83

84 84

85 Now clearly melanoma of 2.5 mm in thickness; SLNB pursued 85

86 Diagnosis: Melanoma, with metastasis to lymph nodes History repeats itself: 25 year old with a thigh lesion, called an irritated Spitz 86

87 87

88 88

89 Persistent and metastatic melanoma noted within 18 months; patient expired within 48 months 89

90 In addition to watching for mitotic figures, Ki-67 or phosphohistone can be used 90

91 91

92 Dodging the pitfall Dermal mitotic figures do not equate with melanoma, but the finding of mitoses mandates caution Spitz nevi and other unconventional melanocytic tumors warrant consideration of molecular assessment and complete excision 92

93 Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism History of melanoma of lip, resected in

94 94

95 95

96 Numbness ensued in 1988 and spread; facial palsy eventually developed years later 96

97

98 98

99

100 82 year old male presents with persistent neurotropic melanoma of the arm, S/P excision of melanoma of 1 mm in thickness 100

101 101

102 102

103 103

104 Ultimate diagnosis: Melanoma with unrecognized neurotropism, with margins involved; narrow excision was insufficient and thus persistence ensued 104

105 Dodging the pitfall Intentionally screen for neurotropism when evaluating each and every melanoma Similarly, intentionally screen for other uncommon findings, including vascular invasion A checklist approach may be helpful Ways to get into trouble Poor technical work Not paying attention Misplay of a pagetoid configuration Being too strong with a Spitz Not knowing the full Spitz spectrum Misplay of desmoplasia Misplay of a biphasic configuration Missing mitoses Missing neurotropism Copy of this talk: Through the meeting organizers If all else fails, go to dermpath.ucsf.edu and contact me 105

David B. Troxel, MD. Common Medicolegal Situations: Misdiagnosis of Melanoma

David B. Troxel, MD. Common Medicolegal Situations: Misdiagnosis of Melanoma Common Medicolegal Situations: Misdiagnosis of Melanoma David B. Troxel, MD Medical Director, The Doctors Company, Napa, California Clinical Professor Emeritus, University of California at Berkeley Past

More information

Dermatopathology. Dr. Rafael Botella Estrada. Hospital La Fe de Valencia

Dermatopathology. Dr. Rafael Botella Estrada. Hospital La Fe de Valencia Dermatopathology Dr. Rafael Botella Estrada. Hospital La Fe de Valencia Melanoma and mimics Dr. Martin Mihm Malignant lesions result from the accumulation of mutations Class I lesions (benign) Class II

More information

Vernon K. Sondak. Department of Cutaneous Oncology Moffitt Cancer Center Tampa, Florida

Vernon K. Sondak. Department of Cutaneous Oncology Moffitt Cancer Center Tampa, Florida Vernon K. Sondak Department of Cutaneous Oncology Moffitt Cancer Center Tampa, Florida Australasian Melanoma Conference 2016 Sydney, NSW, Australia October 29, 2016 Disclosures Dr. Sondak is a compensated

More information

There is NO single Melanoma Stain. > 6000 Mutations in Melanoma. What else can be done to discriminate atypical nevi from melanoma?

There is NO single Melanoma Stain. > 6000 Mutations in Melanoma. What else can be done to discriminate atypical nevi from melanoma? Las Vegas Fall Clinical 2016: The Assessment and Diagnosis of Melanoma Whitney A. High, MD, JD, MEng Associate Professor, Dermatology & Pathology Director of Dermatopathology (Dermatology) University of

More information

Update on Spitzoid and Blue nevus-like melanocytic lesions Emphasis on molecular studies informing diagnosis, prognosis and therapy

Update on Spitzoid and Blue nevus-like melanocytic lesions Emphasis on molecular studies informing diagnosis, prognosis and therapy Update on Spitzoid and Blue nevus-like melanocytic lesions Emphasis on molecular studies informing diagnosis, prognosis and therapy Michael T. Tetzlaff MD, PhD Associate Professor Department of Pathology,

More information

Desmoplastic Melanoma R/O BCC. Clinical Information. 74 y.o. man with lesion on left side of neck r/o BCC

Desmoplastic Melanoma R/O BCC. Clinical Information. 74 y.o. man with lesion on left side of neck r/o BCC R/O BCC Sabine Kohler, M.D. Professor of Pathology and Dermatology Dermatopathology Service Stanford University School of Medicine Clinical Information 74 y.o. man with lesion on left side of neck r/o

More information

Molecular Aspects of Melanocytic Neoplasia. Iwei Yeh MD, PhD University of California, San Francisco

Molecular Aspects of Melanocytic Neoplasia. Iwei Yeh MD, PhD University of California, San Francisco Molecular Aspects of Melanocytic Neoplasia Iwei Yeh MD, PhD University of California, San Francisco Thanks to: Boris Bastian Timothy McCalmont Philip LeBoit Beth Ruben Jeff North Laura Pincus Thaddeus

More information

Michael T. Tetzlaff MD, PhD

Michael T. Tetzlaff MD, PhD Molecular alterations informing the diagnosis of melanocytic tumors Michael T. Tetzlaff MD, PhD Associate Professor Department of Pathology, Section of Dermatopathology Department of Translational and

More information

21/07/2017. The «gray zone» of diagnosis is visible. Nevus Atypical nevus Melanoma. Melanoma ex-blue nevus

21/07/2017. The «gray zone» of diagnosis is visible. Nevus Atypical nevus Melanoma. Melanoma ex-blue nevus Update on the Clinico- Pathological and Molecular Diagnosis of Melanocytic Lesions None to declare Conflicts of interest Belfast pathology Arnaud de la Fouchardière MD, PhD Lyon, France What is new? Today

More information

Conflict of Interest 9/2/2014. Pathogenesis and Comparison of Atypical Spitz Nevi vs Benign Spitz, and Childhood Melanoma

Conflict of Interest 9/2/2014. Pathogenesis and Comparison of Atypical Spitz Nevi vs Benign Spitz, and Childhood Melanoma Pathogenesis and Comparison of Atypical Spitz Nevi vs Benign Spitz, and Childhood Melanoma Martin C. Mihm Jr., M.D., F.A.C.P. Harvard Medical School Brigham and Women s Hospital Dana Farber Cancer Center

More information

A PRACTICAL APPROACH TO ATYPICAL MELANOCYTIC LESIONS BIJAN HAGHIGHI M.D, DIRECTOR OF DERMATOPATHOLOGY, ST. JOSEPH HOSPITAL

A PRACTICAL APPROACH TO ATYPICAL MELANOCYTIC LESIONS BIJAN HAGHIGHI M.D, DIRECTOR OF DERMATOPATHOLOGY, ST. JOSEPH HOSPITAL A PRACTICAL APPROACH TO ATYPICAL MELANOCYTIC LESIONS BIJAN HAGHIGHI M.D, DIRECTOR OF DERMATOPATHOLOGY, ST. JOSEPH HOSPITAL OBJECTIVES Discuss current trends and changing concepts in our understanding of

More information

Malignant tumors of melanocytes: Part 1. Deba P Sarma, MD., Omaha

Malignant tumors of melanocytes: Part 1. Deba P Sarma, MD., Omaha Malignant tumors of melanocytes: Part 1 Deba P Sarma, MD., Omaha The melanocytic tumor is one of the most difficult and confusing areas in Dematopathology. It is true that most (95%) of such lesions are

More information

Melanoma and the genes: Molecular alterations informing the diagnosis of melanocytic tumors

Melanoma and the genes: Molecular alterations informing the diagnosis of melanocytic tumors Melanoma and the genes: Molecular alterations informing the diagnosis of melanocytic tumors Michael T. Tetzlaff MD, PhD Associate Professor Department of Pathology, Section of Dermatopathology Department

More information

Genetic Testing: When should it be ordered? Julie Schloemer, MD Dermatology

Genetic Testing: When should it be ordered? Julie Schloemer, MD Dermatology Genetic Testing: When should it be ordered? Julie Schloemer, MD Dermatology Outline Germline testing CDKN2A BRCA2 BAP1 Somatic testing Gene expression profiling (GEP) BRAF Germline vs Somatic testing

More information

The Enigmatic Spitz Lesion

The Enigmatic Spitz Lesion The Enigmatic Spitz Lesion The Dawn of Spitz S Spitz Sophie Spitz Melanomas of Childhood ; Am J Pathol 1948 1910-1956 13 children (18 mo - 12 yrs) 12/13 had a benign clinical course Sophie Spitz Born 1910

More information

Protocol applies to melanoma of cutaneous surfaces only.

Protocol applies to melanoma of cutaneous surfaces only. Melanoma of the Skin Protocol applies to melanoma of cutaneous surfaces only. Procedures Biopsy (No Accompanying Checklist) Excision Re-excision Protocol revision date: January 2005 Based on AJCC/UICC

More information

Case 26 Male 37. Right jawline 5mm nodule?keloid. The best diagnosis is:

Case 26 Male 37. Right jawline 5mm nodule?keloid. The best diagnosis is: Case 26 Male 37. Right jawline 5mm nodule?keloid. The best diagnosis is: A. Desmoplastic Spitz naevus B. Atypical Spitz Tumour C. Spitzoid melanoma D. Deep penetrating naevus E. Spitz naevus Case 26: M

More information

Melanocytic Lesions: Use of Immunohistochemistry and Special Studies Napa Valley 2018

Melanocytic Lesions: Use of Immunohistochemistry and Special Studies Napa Valley 2018 Melanocytic Lesions: Use of Immunohistochemistry and Special Studies Napa Valley 2018 Victor G. Prieto, MD, PhD Professor Depts. of Pathology and Dermatology University of Texas - MD Anderson Cancer Center

More information

6/22/2015. Original Paradigm. Correlating Histology and Molecular Findings in Melanocytic Neoplasms

6/22/2015. Original Paradigm. Correlating Histology and Molecular Findings in Melanocytic Neoplasms 6 Correlating Histology and Molecular Findings in Melanocytic Neoplasms Pedram Gerami MD, Associate Professor of Dermatology and Pediatrics at Northwestern University Disclosures: I have been a consultant

More information

Interesting Case Series. Desmoplastic Melanoma

Interesting Case Series. Desmoplastic Melanoma Interesting Case Series Desmoplastic Melanoma Anthony Maurice Kordahi, MD, Joshua B. Elston, MD, Ellen M. Robertson, MD, and C. Wayne Cruse, MD Division of Plastic Surgery, Department of Surgery, University

More information

Melanocytic proliferations in sundamaged

Melanocytic proliferations in sundamaged Atypical Spitzoid Tumor: What Does It Mean And How Should It Be Managed? Melanocytic proliferations in sundamaged skin Jane L. Messina, Jane L. Messina MD International Melanoma Pathology Working Group

More information

Management of pediatric melanocytic lesions

Management of pediatric melanocytic lesions Open Journal of Clinical & Medical Case Reports Management of pediatric melanocytic lesions Volume 3 (2017) Issue 8 ISSN 2379-1039 Jin Kim, BS; Emmanuel Gabriel MD, PhD; Weiguo Liu MD, PhD; Lin Lin MD,

More information

Diagnoses of Cases 1. Lentigo, other melanosis and the acquired nevus 2. Variations on the acquired nevus 3. Dermal melanocytosis

Diagnoses of Cases 1. Lentigo, other melanosis and the acquired nevus 2. Variations on the acquired nevus 3. Dermal melanocytosis Diagnoses of Cases 1. Lentigo, other melanosis and the acquired nevus 1 1A. Lentigo simplex 4 1B. Psoralens and ultraviolet A (PUVA) lentigo 6 1C. Solar lentigo 8 1D. Café au lait macule 10 1E. Ink-spot

More information

Cutaneous Melanoma: Epidemiology (USA) The Sentinel Node in Head and Neck Melanoma. Cutaneous Melanoma: Epidemiology (USA)

Cutaneous Melanoma: Epidemiology (USA) The Sentinel Node in Head and Neck Melanoma. Cutaneous Melanoma: Epidemiology (USA) The Sentinel Node in Head and Neck Melanoma Cutaneous Melanoma: Epidemiology (USA) 6 th leading cause of cancer among men and women 68,720 new cases of invasive melanoma in 2009 8,650 deaths from melanoma

More information

Malignant tumors of melanocytes : Part 3. Deba P Sarma, MD., Omaha

Malignant tumors of melanocytes : Part 3. Deba P Sarma, MD., Omaha Malignant tumors of melanocytes : Part 3 Deba P Sarma, MD., Omaha Let s go over one case of melanoma using the following worksheet. Of the various essential information that needs to be included in the

More information

Melanoma Update: 8th Edition of AJCC Staging System

Melanoma Update: 8th Edition of AJCC Staging System Melanoma Update: 8th Edition of AJCC Staging System Rosalie Elenitsas, M.D. Professor of Dermatology Director, Dermatopathology University of Pennsylvania DISCLOSURE OF RELATIONSHIPS WITH INDUSTRY None

More information

Simulators of melanoma

Simulators of melanoma Simulators of melanoma Philip E. LeBoit, M.D. Depts. of Pathology and Dermatology University of California, San Francisco Simulators of melanoma Simulators of melanoma in situ Melanocytic Non-melanocytic

More information

1/10/2018. Soft Tissue Tumors Showing Melanocytic Differentiation. Overview. Desmoplastic/ Spindle Cell Melanoma

1/10/2018. Soft Tissue Tumors Showing Melanocytic Differentiation. Overview. Desmoplastic/ Spindle Cell Melanoma 2016 MFMER slide-1 2016 MFMER slide-2 2016 MFMER slide-3 Soft Tissue Tumors Showing Melanocytic Differentiation Andrew L. Folpe, M.D. Professor of Laboratory Medicine and Pathology Mayo Clinic, Rochester,

More information

Case RAC7783. M46. Ear. Mole. r/o MM.?Blue naevus RAC7783

Case RAC7783. M46. Ear. Mole. r/o MM.?Blue naevus RAC7783 Case RAC7783. M46. Ear. Mole. r/o MM.?Blue naevus RAC7783 Pie Chart Participants N=74 Benign: 48 N=74 Blue naevus: 38 Intradermal: 12 DPN: 10 Compound 3 Clonal: 3; Spitz 2; Special Site: 1; Congenital:

More information

Melanocytic lesions on Genital Skin Melanoma vs. Melanocytic Nevus, Revisited. Timothy H. McCalmont, MD University of California, San Francisco

Melanocytic lesions on Genital Skin Melanoma vs. Melanocytic Nevus, Revisited. Timothy H. McCalmont, MD University of California, San Francisco Melanocytic lesions on Genital Skin Melanoma vs. Melanocytic Nevus, Revisited Timothy H. McCalmont, MD, San Francisco I. IS IT BENIGN OR IS IT MALIGNANT? One of the commonest determinations we make as

More information

Financial disclosures

Financial disclosures Mesenchymal Neoplasms with Melanocytic Differentiation By Konstantinos Linos MD, FCAP, FASDP Bone, Soft Tissue and Dermatopathology Assistant Professor of Pathology Dartmouth-Hitchcock Medical Center Geisel

More information

Female 18. Deeply pigmented lesion on trunk.?warty naevus?seborrhoeic keratosis?malignant melanoma. The best diagnosis is:

Female 18. Deeply pigmented lesion on trunk.?warty naevus?seborrhoeic keratosis?malignant melanoma. The best diagnosis is: Female 18. Deeply pigmented lesion on trunk.?warty naevus?seborrhoeic keratosis?malignant melanoma. The best diagnosis is: A. deep penetrating naevus B. naevoid malignant melanoma C. pigment synthesising

More information

Benign and malignant epithelial lesions: Seborrheic keratosis: A common benign pigmented epidermal tumor occur in middle-aged or older persons more

Benign and malignant epithelial lesions: Seborrheic keratosis: A common benign pigmented epidermal tumor occur in middle-aged or older persons more Benign and malignant epithelial lesions: Seborrheic keratosis: A common benign pigmented epidermal tumor occur in middle-aged or older persons more common on the trunk; but extremities, head and neck are

More information

Primary Cutaneous Melanoma Pathology Reporting Proforma DD MM YYYY. *Tumour site. *Specimen laterality. *Specimen type

Primary Cutaneous Melanoma Pathology Reporting Proforma DD MM YYYY. *Tumour site. *Specimen laterality. *Specimen type Primary Cutaneous Melanoma Pathology Reporting Proforma Includes the International Collaboration on Cancer reporting dataset denoted by * Family name Given name(s) Date of birth DD MM YYYY Sex Male Female

More information

10/2/17. MELTUMP, SAMPUS, AST.An Algorithmic Approach to Challenging (Often Borderline) Melanocytic Tumors. An Introduction to SNP Arrays

10/2/17. MELTUMP, SAMPUS, AST.An Algorithmic Approach to Challenging (Often Borderline) Melanocytic Tumors. An Introduction to SNP Arrays MELTUMP, SAMPUS, AST.An Algorithmic Approach to Challenging (Often ) Melanocytic Tumors An Introduction to SNP Arrays Rajiv M. Patel, M.D. RCPA NZ ASM 2017 (11:45-12:30pm, Saturday, 23-09-17) Why do we

More information

Desmoplastic Melanoma: Clinical Behavior and Management Implications

Desmoplastic Melanoma: Clinical Behavior and Management Implications Desmoplastic Melanoma: Clinical Behavior and Management Implications Collier S. Pace, MD, a Jyoti P. Kapil, MD, b Luke G. Wolfe, MS, c Brian J. Kaplan, MD, c and James P. Neifeld, MD c a Division of Plastic

More information

Page 1 of 3. We suggest the following changes:

Page 1 of 3. We suggest the following changes: Page 1 of 3 Loren E. Clarke, M.D. Myriad Genetic Laboratories, Inc. 320 Wakara Way, Salt Lake City, UT 84108 Phone: 801.883.3470 Email: lclarke@myriad.com Date of Request: June 2017 NCCN Guidelines Panel:

More information

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors

We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists. International authors and editors We are IntechOpen, the world s leading publisher of Open Access books Built by scientists, for scientists 3,500 108,000 1.7 M Open access books available International authors and editors Downloads Our

More information

Patricia Chevez-Barrrios AAOOP-USCAP /12/2016

Patricia Chevez-Barrrios AAOOP-USCAP /12/2016 Biomarkers in Ocular Melanoma Patricia Chévez-Barrios, MD Pathology and Genomic Medicine, Houston Methodist Hospital Professor of Pathology and Laboratory Medicine and Ophthalmology, Weill Cornell Medical

More information

Melanocytic Tumours. Molecular Biology 02/06/2015. Cutaneous Melanocytic Tumours Introduction. Thomas Brenn. Intermediate Malignancy

Melanocytic Tumours. Molecular Biology 02/06/2015. Cutaneous Melanocytic Tumours Introduction. Thomas Brenn. Intermediate Malignancy Cutaneous Melanocytic Tumours Introduction Melanocytic Tumours: Update on Epidemiology and Molecular Biology Thomas Brenn Wide clinical and morphological spectrum Ranging from benign naevi to melanoma

More information

Melanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG

Melanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG Melanoma-Back to Basics I Thought I Knew Ya! Paul K. Shitabata, M.D. Dermatopathologist APMG At tumor board, a surgeon insists that all level II melanomas are invasive since they have broken through the

More information

Update on 8 th Edition Cutaneous AJCC Staging of Primary Cutaneous Melanoma. Michael T. Tetzlaff MD, PhD

Update on 8 th Edition Cutaneous AJCC Staging of Primary Cutaneous Melanoma. Michael T. Tetzlaff MD, PhD Update on 8 th Edition Cutaneous AJCC Staging of Primary Cutaneous Melanoma Michael T. Tetzlaff MD, PhD Associate Professor Departments of Pathology (Dermatopathology) and Translational and Molecular Pathology

More information

Springer Healthcare. Staging and Diagnosing Cutaneous Melanoma. Concise Reference. Dirk Schadendorf, Corinna Kochs, Elisabeth Livingstone

Springer Healthcare. Staging and Diagnosing Cutaneous Melanoma. Concise Reference. Dirk Schadendorf, Corinna Kochs, Elisabeth Livingstone Concise Reference Staging and Diagnosing Cutaneous Melanoma Dirk Schadendorf, Corinna Kochs, Elisabeth Livingstone Extracted from Handbook of Cutaneous Melanoma: A Guide to Diagnosis and Treatment Published

More information

Michael T. Tetzlaff MD, PhD

Michael T. Tetzlaff MD, PhD American Joint Cancer Committee (AJCC) staging system for primary cutaneous melanoma (8 th Edition) and principles of sentinel lymph node evaluation Emphasis on concise and accurate reporting of primary

More information

Reviewers' comments: Reviewer #1 (Remarks to the Author):

Reviewers' comments: Reviewer #1 (Remarks to the Author): Reviewers' comments: Reviewer #1 (Remarks to the Author): In this study the authors analysed 18 deep penetrating nevi for oncogenic genomic changes (single nucleotide variations, insertions/deletions,

More information

Case 231: F7. Exophytic naevus over left trapezious. Grown over a few weeks. Iniitally flat.?spitz naevus,?malignant

Case 231: F7. Exophytic naevus over left trapezious. Grown over a few weeks. Iniitally flat.?spitz naevus,?malignant Case 231: F7. Exophytic naevus over left trapezious. Grown over a few weeks. Iniitally flat.?spitz naevus,?malignant Dermoscopy: coarse vascular structures. c/o A, B, C RAC7750 Case 231: F7. Exophytic

More information

Guy Perrot (Ги Перро)

Guy Perrot (Ги Перро) НАУЧНО-ПРАКТИЧЕСКАЯ КОНФЕРЕНЦИЯ (МАСТЕР-КЛАСС) «ПРАКТИЧЕСКИЕ АСПЕКТЫ ДИАГНОСТИКИ И ЛЕЧЕНИЯ МЕЛАНОМЫ КОЖИ» DIAGNOSTIC AND PITFALLS IN MELANOMA Guy Perrot (Ги Перро) MD PHD pathologist, University Hospital

More information

المركب النموذج--- سبيتز وحمة = Type Spitz's Nevus, Compound SPITZ NEVUS 1 / 7

المركب النموذج--- سبيتز وحمة = Type Spitz's Nevus, Compound SPITZ NEVUS 1 / 7 SPITZ NEVUS 1 / 7 Epidemiology An annual incidence rate of 1.4 cases of Spitz nevus per 100,000 individuals has been estimated in Australia, compared with 25.4 per 100,000 individuals for cutaneous melanoma

More information

Dermatologica Sinica

Dermatologica Sinica DERMATOLOGICA SINICA 30 (2012) 57e61 Contents lists available at SciVerse ScienceDirect Dermatologica Sinica journal homepage: http://www.derm-sinica.com CASE REPORT Pigmented epithelioid melanocytoma:

More information

PHILIP E. LEBOIT. Histological Diagnosis of Nevi and Melanoma

PHILIP E. LEBOIT. Histological Diagnosis of Nevi and Melanoma GUIDO MASSI PHILIP E. LEBOIT Histological Diagnosis of Nevi and Melanoma GUIDO MASSI PHILIP E. LEBOIT Histological Diagnosis of Nevi and Melanoma With Contributions by PAOLA PASQUINI and FRANCESCO FEDERICO,

More information

Special slide seminar

Special slide seminar Special slide seminar Tomáš Rozkoš The Fingerland Department of Pathology Charles University Medical Faculty and Faculty Hospital in Hradec Králové Czech Republic Case history, 33 years old resistance

More information

Updates on Melanoma: Are You Following the Latest Guidelines of Care? Jerry Brewer, MD

Updates on Melanoma: Are You Following the Latest Guidelines of Care? Jerry Brewer, MD Updates on Melanoma: Are You Following the Latest Guidelines of Care? Jerry Brewer, MD Disclosure Statement Update on Melanoma Are You Following the Latest Guidelines of Care? I, Jerry D. Brewer, MD, do

More information

Cellular Neurothekeoma

Cellular Neurothekeoma Cellular Neurothekeoma Scott W Binder, MD Pritzker Professor of Pathology & Dermatology Sr. Vice Chair Director, Pathology Clinical Services Chief, Dermatopathology Geffen/UCLA School of Medicine Clinical

More information

K Blessing, J J H Grant, D S A Sanders, M M Kennedy, A Husain, P Coburn

K Blessing, J J H Grant, D S A Sanders, M M Kennedy, A Husain, P Coburn J Clin Pathol 2000;53:591 595 591 Papers Pathology, Aberdeen University, Foresterhill, Aberdeen AB25 2ZD, K Blessing Pathology, Birmingham University, Birmingham B15 2TT, D S A Sanders Pathology, Heartlands

More information

Pathological diagnosis of melanocytic tumours: clues and pitfalls # Richard A. Scolyer 1,2,3* and Stanley W. McCarthy 1,2,3

Pathological diagnosis of melanocytic tumours: clues and pitfalls # Richard A. Scolyer 1,2,3* and Stanley W. McCarthy 1,2,3 Pathological diagnosis of melanocytic tumours: clues and pitfalls # Richard A. Scolyer 1,2,3* and Stanley W. McCarthy 1,2,3 1 Tissue Pathology and Diagnostic Oncology, Royal Prince Alfred Hospital, Sydney,

More information

Dr Rosalie Stephens. Mr Richard Martin. Medical Oncologist Auckland City Hospital Auckland

Dr Rosalie Stephens. Mr Richard Martin. Medical Oncologist Auckland City Hospital Auckland Dr Rosalie Stephens Medical Oncologist Auckland City Hospital Auckland Mr Richard Martin General Surgeon Melanoma Unit Team Waitemata District Health Board Auckland 8:30-9:25 WS #99: Interactive Case Studies

More information

Toby Maurer, MD University of California, San Francisco. Lifetime risk of an American developing melanoma

Toby Maurer, MD University of California, San Francisco. Lifetime risk of an American developing melanoma Distinguishing Pigmented Skin Lesions and Melanoma Toby Maurer, MD University of California, San Francisco Epidemiology of Melanoma Lifetime risk of an American developing melanoma 1935: 1 in 1500 1980:

More information

Dermatopathology: The tumor is composed of keratinocytes which show atypia, increase mitoses and abnormal mitoses.

Dermatopathology: The tumor is composed of keratinocytes which show atypia, increase mitoses and abnormal mitoses. Squamous cell carcinoma (SCC): A common malignant tumor of keratinocytes arising in the epidermis, usually from a precancerous condition: 1- UV induced actinic keratosis, usually of low grade malignancy.

More information

Basal cell carcinoma 5/28/2011

Basal cell carcinoma 5/28/2011 Goal of this Presentation A practical approach to the diagnosis of cutaneous carcinomas and their mimics Thaddeus Mully, MD University of California San Francisco To review common non-melanoma skin cancers

More information

Associate Clinical Professor of Dermatology MUSC

Associate Clinical Professor of Dermatology MUSC Re-excision of Moderately Dysplastic Nevi: Should we or shouldn t we? John C. Maize, Jr, M.D. Dermatologist and Dermatopathologist Trident Dermatology, Charleston SC Associate Clinical Professor of Dermatology

More information

The Relevance of Cytologic Atypia in Cutaneous Neural Tumors

The Relevance of Cytologic Atypia in Cutaneous Neural Tumors The Relevance of Cytologic Atypia in Cutaneous Neural Tumors Recent Findings - New Developments New Problems Zsolt B. Argenyi, M.D. Professor of Pathology & Dermatology Director of Dermatopathology Department

More information

WHAT DOES THE PATHOLOGY REPORT MEAN?

WHAT DOES THE PATHOLOGY REPORT MEAN? Melanoma WHAT IS MELANOMA? Melanoma is a type of cancer that affects cells called melanocytes. These cells are found mainly in skin but also in the lining of other areas such as nose and rectum, and also

More information

Cutaneous Mesenchymal Neoplasms with EWSR1 Rearrangement

Cutaneous Mesenchymal Neoplasms with EWSR1 Rearrangement Cutaneous Mesenchymal Neoplasms with EWSR1 Rearrangement By Konstantinos Linos MD, FCAP, FASDP Bone, Soft Tissue and Dermatopathology Assistant Professor of Pathology Dartmouth-Hitchcock Medical Center

More information

EARLY ONLINE RELEASE

EARLY ONLINE RELEASE EARLY ONLINE RELEASE Note: This article was posted on the Archives Web site as an Early Online Release. Early Online Release articles have been peer reviewed, copyedited, and reviewed by the authors. Additional

More information

Pathology of the skin. 2nd Department of Pathology, Semmelweis University

Pathology of the skin. 2nd Department of Pathology, Semmelweis University Pathology of the skin 2nd Department of Pathology, Semmelweis University Histology of the skin Epidermis: Stratum corneum Stratum granulosum Stratum spinosum Stratum basale Dermis: papillary and reticular

More information

Less Common Variants of Cutaneous Melanoma

Less Common Variants of Cutaneous Melanoma Less Common Variants of Cutaneous Melanoma Raymond L. Barnhill* 1, G. Peter Sarantopoulos 1, and Kapil Gupta 2 1 Department of Pathology and Laboratory Medicine, University of California, Los Angeles,

More information

Supplementary Figure 1. Spitzoid Melanoma with PPFIBP1-MET fusion. (a) Histopathology (4x) shows a domed papule with melanocytes extending into the

Supplementary Figure 1. Spitzoid Melanoma with PPFIBP1-MET fusion. (a) Histopathology (4x) shows a domed papule with melanocytes extending into the Supplementary Figure 1. Spitzoid Melanoma with PPFIBP1-MET fusion. (a) Histopathology (4x) shows a domed papule with melanocytes extending into the deep dermis. (b) The melanocytes demonstrate abundant

More information

An Overview of Melanoma. Harriet Kluger, M.D. Associate Professor Section of Medical Oncology Yale Cancer Center

An Overview of Melanoma. Harriet Kluger, M.D. Associate Professor Section of Medical Oncology Yale Cancer Center An Overview of Melanoma Harriet Kluger, M.D. Associate Professor Section of Medical Oncology Yale Cancer Center Melanoma Statistics Median age at presentation 45-55 55 years Incidence: 2003 54,200 cases

More information

Toby Maurer, MD University of California, San Francisco. Lifetime risk of an American developing melanoma

Toby Maurer, MD University of California, San Francisco. Lifetime risk of an American developing melanoma Distinguishing Pigmented Skin Lesions and Melanoma Toby Maurer, MD University of California, San Francisco Epidemiology of Melanoma Lifetime risk of an American developing melanoma 1935: 1 in 1500 1980:

More information

Conflicts of Interest

Conflicts of Interest Challenging Melanocytic Lesions Carlos N. Prieto-Granada M.D. Assistant Professor University of Alabama at Birmingham (UAB) Department of Pathology 2017 AAD Annual Meeting 3/2/17 - Orlando, FL None Conflicts

More information

BAP-oma & BEYOND MICHAEL A NOWAK, MD

BAP-oma & BEYOND MICHAEL A NOWAK, MD BAP-oma & BEYOND MICHAEL A NOWAK, MD CONFLICTS No conflicts with the content of this lecture BAP-oma Wiesner 2011: Families with multiple tan dome-shaped papules of head, neck, trunk, and extremities.

More information

Benign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc

Benign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc 1 Benign versus Cancerous Lesions How to tell the difference FMF 2014 Christie Freeman MD, CCFP, DipPDerm, MSc Benign lesions Seborrheic Keratoses: Warty, stuck-on Genetics and birthdays Can start in late

More information

Index. Springer-Verlag Berlin Heidelberg 2017 J.A. Plaza, V.G. Prieto, Pathology of Pigmented Skin Lesions, DOI /

Index. Springer-Verlag Berlin Heidelberg 2017 J.A. Plaza, V.G. Prieto, Pathology of Pigmented Skin Lesions, DOI / A Acral lentiginous (mucosal lentiginous) melanoma, 483 Acral lentiginous melanoma (ALM) asymmetric and irregular lentiginous junctional growth, 431 clinical features, 427 428 differential diagnosis, 428

More information

Which melanoma patients benefit from genetic testing?

Which melanoma patients benefit from genetic testing? Which melanoma patients benefit from genetic testing? Michael A. Marchetti, MD Assistant Attending, Dermatology Service Memorial Sloan Kettering Cancer Center American Academy of Dermatology Annual Meeting

More information

5/21/2018. Disclosures. Consulting: Myriad Genetics SciBase. Superficial Atypical Melanocytic Proliferations. SSM, LMM and (some of) their Simulants

5/21/2018. Disclosures. Consulting: Myriad Genetics SciBase. Superficial Atypical Melanocytic Proliferations. SSM, LMM and (some of) their Simulants Disclosures Consulting: Myriad Genetics SciBase Superficial Atypical Melanocytic Proliferations SSM, LMM and (some of) their Simulants 1 Melanomas and Nevi. Nevi are important mainly in relation to melanoma

More information

Melanoma 6/2/2011. Classification and Prognosis. Melanoma Statistics. American Cancer Society

Melanoma 6/2/2011. Classification and Prognosis. Melanoma Statistics. American Cancer Society University of Pennsylvania, Ben Franklin in front of Charles Addams Building Melanoma Classification and Prognosis Emphasizing Pathology & History David Elder University of Pennsylvania Melanoma Statistics

More information

Histopathology of Melanoma

Histopathology of Melanoma THE YALE JOURNAL OF BIOLOGY AND MEDICINE 48, 409-416 (1975) Histopathology of Melanoma G. J. WALKER SMITH Department ofpathology, Yale University School ofmedicine, 333 Cedar Street, New Haven, Connecticut

More information

2/6/2018. Original Paradigm. Clonal Chromosomal A berrations. Only 20% of Spitz Nevi 95% 6p, 7q, 17q, 20q, 4q,8q, 1q, 11q. Isolated Gain in 11p

2/6/2018. Original Paradigm. Clonal Chromosomal A berrations. Only 20% of Spitz Nevi 95% 6p, 7q, 17q, 20q, 4q,8q, 1q, 11q. Isolated Gain in 11p Molecular Diagnostics for Melanocytic Neoplasms: Moving towards a Revolution in the Management of Melanocytic Neoplasms Pedr am Gerami MD Associate Professor of Dermatology, Pathology and Pediatrics at

More information

Neurotropic cutaneous malignant melanoma with contiguous spread to spinal cord, an extremely rare presentation

Neurotropic cutaneous malignant melanoma with contiguous spread to spinal cord, an extremely rare presentation Case Report Neurotropic cutaneous malignant melanoma with contiguous spread to spinal cord, an extremely rare presentation Sheikh Asad, Idrees Sher, Jens Peters-Willke, Peter Jessup Departments of Neurosurgery

More information

Clinicopathologic Self- Assessment S003 AAD 2017

Clinicopathologic Self- Assessment S003 AAD 2017 Clinicopathologic Self- Assessment S003 AAD 2017 Clay J. Cockerell, M.D. Director, Cockerell Dermatopathology Director, Division of Dermatopathology UT Southwestern Medical Center July 2017 No relevant

More information

Diploma Examination. Dermatopathology: First paper. Tuesday 20 March Candidates must answer FOUR questions. Time allowed: 3 hours

Diploma Examination. Dermatopathology: First paper. Tuesday 20 March Candidates must answer FOUR questions. Time allowed: 3 hours Dermatopathology: First paper Tuesday 20 March 2018 Candidates must answer FOUR questions Time allowed: 3 hours 1. Give an account of the genetic aberrations encountered in Spitzoid neoplasms and how these

More information

أملس عضلي غرن = Leiomyosarcoma. Leiomyosarcoma 1 / 5

أملس عضلي غرن = Leiomyosarcoma. Leiomyosarcoma 1 / 5 Leiomyosarcoma 1 / 5 EPIDEMIOLOGY Exact incidence is unknown, but older studies suggest that leiomyosarcomas comprise approximately 3 percent of soft-tissue sarcomas. Superficial leiomyosarcoma occurs

More information

Histotechnological problems in dermatopathology and their possible consequences

Histotechnological problems in dermatopathology and their possible consequences Histotechnological problems in dermatopathology and their possible consequences Zsolt B. Argenyi, M.D. Professor of Pathology & Dermatology Director of Dermatopathology University of Washington, Seattle,

More information

Selected Pseudomalignant Soft Tissue Tumors of the Skin and Subcutis

Selected Pseudomalignant Soft Tissue Tumors of the Skin and Subcutis Selected Pseudomalignant Soft Tissue Tumors of the Skin and Subcutis Andrew L. Folpe, M.D. Professor of Laboratory Medicine and Pathology Mayo Clinic, Rochester, MN folpe.andrew@mayo.edu 2016 MFMER slide-1

More information

Contrast with Australian Guidelines A/Pr Pascale Guitera,

Contrast with Australian Guidelines A/Pr Pascale Guitera, Contrast with Australian Guidelines A/Pr Pascale Guitera, Dermatologist, Sydney University NO CONFLICT OF INTEREST Sydney Melanoma Diagnostic Centre, RPAH 2011 2008 225 pages 16 pages http://www.cancer.org.au/file/healthprofessionals/clinica

More information

Maligna Melanoma and Atypical Fibroxanthoma: An Unusual Collision Tumour G Türkcü 1, A Keleş 1, U Alabalık 1, D Uçmak 2, H Büyükbayram 1 ABSTRACT

Maligna Melanoma and Atypical Fibroxanthoma: An Unusual Collision Tumour G Türkcü 1, A Keleş 1, U Alabalık 1, D Uçmak 2, H Büyükbayram 1 ABSTRACT Maligna Melanoma and Atypical Fibroxanthoma: An Unusual Collision Tumour G Türkcü 1, A Keleş 1, U Alabalık 1, D Uçmak 2, H Büyükbayram 1 ABSTRACT Two different neoplasia in the same biopsy material called

More information

Immunohistochemistry in Dermatopathology

Immunohistochemistry in Dermatopathology Immunohistochemistry in Dermatopathology Tammie Ferringer, MD Context. Immunohistochemistry is not a diagnostic test but a highly valuable tool that requires interpretation within a context. Objective.

More information

Lichenoid Tissue Reaction in Malignant Melanoma A Potential Diagnostic Pitfall

Lichenoid Tissue Reaction in Malignant Melanoma A Potential Diagnostic Pitfall natomic Pathology / LICHENOID TISSUE RECTION IN MLIGNNT MELNOM Lichenoid Tissue Reaction in Malignant Melanoma Potential Diagnostic Pitfall CPT Scott R. Dalton, MC, US, 1,3 Capt Matt. aptista, USF, MC,

More information

Financial disclosures

Financial disclosures Cutaneous Mesenchymal Neoplasms with EWSR1 Rearrangement By Konstantinos Linos MD, FCAP, FASDP Bone, Soft Tissue and Dermatopathology Assistant Professor of Pathology Dartmouth-Hitchc Geisel School of

More information

Diploma examination. Dermatopathology: First paper. Tuesday 21 March Candidates must answer FOUR questions ONLY. Time allowed: Three hours

Diploma examination. Dermatopathology: First paper. Tuesday 21 March Candidates must answer FOUR questions ONLY. Time allowed: Three hours Dermatopathology: First paper Tuesday 21 March 2017 1. Discuss the role of fluorescent in-situ hybridization (FISH) and emerging molecular techniques in the diagnosis of cutaneous melanocytic lesions,

More information

MAPK Pathway. CGH Next Generation Sequencing. Molecular Tools in Care of Patients with Pigmented Lesions 7/20/2017

MAPK Pathway. CGH Next Generation Sequencing. Molecular Tools in Care of Patients with Pigmented Lesions 7/20/2017 Molecular Tools in Care of Patients with Pigmented Lesions Tammie Ferringer, MD Geisinger Medical Center, Danville, PA tferringer@geisinger.edu DISCLOSURE OF RELATIONSHIPS WITH INDUSTRY Tammie Ferringer,

More information

The Pathology of Neoplasia Part II

The Pathology of Neoplasia Part II The Pathology of Neoplasia Part II February 2018 PAUL BOGNER, MD A S S O C I A T E P R O F E S S O R O F O N C O L O G Y P A T H O L O G Y A N D D E R M A T O L O G Y Clinical goals of cancer pathology

More information

MELANOMA IN ADOLESCENTS AND YOUNG ADULTS

MELANOMA IN ADOLESCENTS AND YOUNG ADULTS Cancer in Adolescents and Young Adults (AYA) Working Group MELANOMA IN ADOLESCENTS AND YOUNG ADULTS Emmanouil Saloustros MD, DSc General Hospital of Heraklion Venizelio Heraklion, Crete, Greece ESMO Preceptorship

More information

Published Ahead of Print on December 14, 2009 as /JCO J Clin Oncol by American Society of Clinical Oncology

Published Ahead of Print on December 14, 2009 as /JCO J Clin Oncol by American Society of Clinical Oncology Published Ahead of Print on December 14, 2009 as 10.1200/JCO.2009.24.7734 The latest version is at http://jco.ascopubs.org/cgi/doi/10.1200/jco.2009.24.7734 JOURNAL OF CLINICAL ONCOLOGY O R I G I N A L

More information

LENTIGO SIMPLEX. Epidemiology

LENTIGO SIMPLEX. Epidemiology LENTIGO SIMPLEX Epidemiology The frequency of lentigo simplex in children and adults has not been determined. There does not appear to be a racial or gender predilection. Lentigo simplex is the most common

More information

Self assessment case. Dr Saleem Taibjee Dorset County Hospital, Dorchester

Self assessment case. Dr Saleem Taibjee Dorset County Hospital, Dorchester Self assessment case Dr Saleem Taibjee saleemtaibjee@gmail.com Dorset County Hospital, Dorchester Clinical details 34-year-old man: Shave excision Skin tag / papilloma left thigh The best diagnosis is:

More information

Metastatic Melanoma. Cynthia Kwong February 16, 2017 SUNY Downstate Medical Center Department of Surgery Grand Rounds

Metastatic Melanoma. Cynthia Kwong February 16, 2017 SUNY Downstate Medical Center Department of Surgery Grand Rounds Metastatic Melanoma Cynthia Kwong February 16, 2017 SUNY Downstate Medical Center Department of Surgery Grand Rounds Case Presentation 77 year old male with previous history of scalp melanoma and thyroid

More information

IT S FUNDAMENTAL MY DEAR WATSON! A SHERLOCKIAN APPROACH TO DERMATOLOGY

IT S FUNDAMENTAL MY DEAR WATSON! A SHERLOCKIAN APPROACH TO DERMATOLOGY IT S FUNDAMENTAL MY DEAR WATSON! A SHERLOCKIAN APPROACH TO DERMATOLOGY Skin, Bones, and other Private Parts Symposium Dermatology Lectures by Debra Shelby, PhD, DNP, FNP-BC, FADNP, FAANP Debra Shelby,

More information

MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB. Friday, February 12, :30 am 11:00 am

MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB. Friday, February 12, :30 am 11:00 am MECHANISMS OF HUMAN DISEASE: LABORATORY SESSION PATHOLOGY OF THE SKIN LAB Friday, February 12, 2012 9:30 am 11:00 am FACULTY COPY GOALS: Describe the basic clinical and morphologic features of various

More information