[Regression in malignant melanoma. Definition, etiopathogenesis, morphology and differential diagnosis].
Malignant melanoma is a neoplasm that more often tends to undergo regression. Clinically, variation in color is perhaps the most important hallmark of primary cutaneous melanoma. The change in color to white, off-white, blue-white and gray-white is a sign of (spontaneous) regression in malignant melanoma. Histopathologically the process starts with a dense lichenoid infiltrate of lymphocytes, and ends with fibrosis and/or melanosis within a thickened papillary dermis. The dense infiltrate of lymphocytes permeates the thin melanoma and destroys the atypical melanocytes in the epidermis and the papillary dermis. A key concern is how to define regression in a reproducible way. Using the following definition, a statistically significant risk of metastases can be demonstrated in thin melanomas (<1.0 mm) with extensive regression (>50%): "fibroplasia with an absence of epidermal and dermal involvement by melanoma cells, but allowing for (lentiginous) single-cell proliferation of atypical melanocytes along the dermo-epidermal junction".
Paredes
B E
BE
Dermatopathologische Gemeinschaftspraxis, Siemensstrasse 6/1, 88048, Friedrichshafen. paredes@dermpath.de
D020405:Dermis / Q000473:pathology; D003937:Diagnosis, Differential; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*; D009365:Neoplasm Regression, Spontaneous / Q000276:immunology / Q000473:pathology*; D009367:Neoplasm Staging; D011379:Prognosis; D012878:Skin Neoplasms / Q000175:diagnosis / Q000276:immunology / Q000473:pathology*