De novo intraepidermal epithelioid melanocytic dysplasia: an emerging entity

Abstract

De novo intraepidermal epithelioid melanocytic dysplasia represents a distinctive form of intraepidermal melanocytic dysplasia. Although these lesions are atypical, they are not diagnostic of melanoma. They are considered a part of the atypical mole phenotype and may define a point in the natural course of melanomagenesis.

Morphologic clues and utility of fluorescence in situ hybridization for the diagnosis of nevoid melanoma

“…In these cases, the junctional component may be well nested, such as in lentiginous junctional melanoma of the elderly type, 10 or be paucicellular with some atypia in the form of focal lentiginous or pagetoid growth, as seen in cases classified as de novo intraepidermal melanocytic dysplasia. 11,12 In our cases, two low power scanning clues to the diagnosis of nevoid melanoma were prominent asymmetry, seen in 49 of 58 cases, and expansion of the dermal papillae, seen in 30 of 58 cases. Both of these morphologic changes were typically the result of expansile nesting.…”

“…Although one might expect the cases with a nevoid SSM pattern or a nevoid lentigo maligna melanoma pattern to show unequivocal changes of melanoma in situ within the epidermis, even some of these cases often do not have a clear in situ component. In these cases, the junctional component may be well nested, such as in lentiginous junctional melanoma of the elderly type, or be paucicellular with some atypia in the form of focal lentiginous or pagetoid growth, as seen in cases classified as de novo intraepidermal melanocytic dysplasia …”

Main clues in the pathologic diagnosis of melanoma: is molecular genetics helping?

“…For all the reasons mentioned earlier, in recent years, the traditional “dichotomic” (benign versus malignant) approach to the diagnosis of MSN is becoming increasingly less popular . The result is, however, also a growing confusion about the so‐called “gray zone” , which can be variously regarded as made by: (i) diagnostic pitfalls; (ii) “intermediate stages” in melanomagenesis; (iii) lesions with conflicting histopathologic criteria; and (iv) lesions with an unpredictable biologic behavior.…”

Supercalifragilisticexpialidocious!

“…To the Editor, I have read with interest and ever growing irritation the paper written by Jessup and Cohen about the entity 'de novo intraepidermal epithelioid melanocytic dysplasia (DNIEMD)', 1 and the comment on it by Magro et al 2 I am well aware of the animosity between schools of pathology, eventually dripping into juicy phrases in publications. It attracts attention and at times that is amusing for the reader.…”