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Additional info for Histological Diagnosis of Nevi and Melanoma
On a literallevel, one does not even see cells but only blue and pink blobs; - melanin in melanoma is dusty and not in coarse granules as in nevus; - inflammatory infiltrate is abundant and uneven in most thin melanomas, scarce (or absent) and perivascular in most "ordinary" compound nevi; - upward migration of single melanocytes . Thi s can occur to a limited extent in the center of a compound nevus. It also occurs in nevi that have been traumatized (evidence of which is subepidermal fibrin and extravasated erythrocytes, and necrosis of superficial keratinocytes).
The dividing line between the "ordinary" junctional nevus and a junctional "dysplastic" nevus may rest on the clinical features in some cases, on the histopathologic ones in others, and may be largely arbitrary. Histological features Histologically (Fig. 3), this nevus has two major aspects : the proliferation of melanocytes along the dermoepidermal junction and the collection of the melanocytes in roundish nests: - proliferation of junctional melanocytes. An increased number of melanocytes in single units is present at the junction.
Miescher nevus is a lesion with a smooth surface, almost always entirely intradermal. The neoplasm develops inside the papillary and reticular dermis occasionally reaching the subcutis. The stereotypical site is the face. From AB Ackerman, M. Magana Garcia, and M. DiLeonardo. Am. J. 1990; 12:193-209 Courtesy of the American Journal ofDermatopathology Note that both diagrams show intradermal forms of these nevi. A few junctional nests can be present, but it seems unlikely that these two forms evolve from junctional nevi.