Dermatopathologist Guide to Melanocytic Lesions: From Benign Nevi to Melanomas

Описание: This video, featuring Dr. Jennifer Vickers, provides an excellent and comprehensive overview of melanocytic lesions in dermatopathology. It's a fantastic resource for anyone looking to deepen their understanding of how to differentiate between benign nevi and various types of melanoma.

The presentation covers a wide range of topics, including:
• Benign Nevi: The video starts by defining the characteristics of a normal nevus before moving on to less common variants like dysplastic, congenital, balloon cell, and blue nevi.
• Challenging Diagnoses: Dr. Vickers explains how to identify a recurrent nevus, which can be mistaken for melanoma due to its atypical appearance, and a Spitz nevus, known for its unique histological pattern.
• Melanoma: The core of the talk is dedicated to melanoma, with detailed examples of melanoma in situ, acral melanoma (on the palms/soles), and the particularly difficult-to-diagnose desmoplastic melanoma.
• BAP1-Inactivated Nevus: The video concludes with a discussion of this specific lesion, highlighting its unique features and its association with an increased risk of certain cancers.

To view the slides for this presentation, please follow this link:
https://sagis.pathpresenter.net/publi...

ANSWER SLIDES:
2:02 Slide 1: Melanocytic nevus
4:28 Slide 2: Compound dysplastic melanocytic nevus
6:23 Slide 3: Congenital melanocytic nevus
8:38 Slide 4: Balloon cell nevus
11:02 Slide 5: “Common” (dendritic, sclerotic) blue nevus
12:54 Slide 6: “Cellular” (spindled, fascicular) blue nevus
14:59 Slide 7: Compound Spitz nevus
18:28 Slide 8: Persistent (Recurrent) melanocytic nevus
20:56 Slide 9: MMIS and associated HSV
25:24 Slide 10: Acral melanoma
27:13 Slide 11: Desmoplastic melanoma
33:05 Slide 12: BAP-1 inactivated melanocytic nevus

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Chapter Breakdown:
Chapter 1: Introduction and The Basics of a Benign Nevus [00:01]
The video introduces the topic of melanocytic lesions with Dr. Jennifer Vickers. It then explains the key characteristics of a benign nevus, emphasizing its symmetrical shape and the maturation of melanocytes as they move deeper into the dermis.

Chapter 2: Dysplastic Nevus [04:32]
This section covers the dysplastic nevus, highlighting features like "shouldering," where the epidermal component is wider than the dermal one, and "bridging," where rete ridges connect. It also mentions subtle cytological atypia.

Chapter 3: Compound Congenital Nevus [06:23]
The video describes the congenital nevus, noting a "windblown" appearance of melanocytes and their tendency to follow adnexal structures like hair follicles.

Chapter 4: Balloon Cell Nevus & Blue Nevus [01:11:08]
This chapter covers two distinct types of nevi. The balloon cell nevus is characterized by large, foamy clear cells. The blue nevus is defined by its deep pigmentation, sclerotic stroma, and dendritic melanocytes.

Chapter 5: Cellular Blue Nevus & Spitz Nevus [01:13:02]
The video delves into the cellular blue nevus, which involves the entire dermis and has two cell populations. It then discusses the Spitz nevus, which is known for its spindle-shaped melanocytes that can appear in a vertical, "bunch of bananas" pattern.

Chapter 6: Recurrent Nevus [01:18:36]
This section explains the characteristics of a recurrent nevus after a biopsy. A key feature is the presence of a scar with an atypical melanocytic proliferation on top, which can be mistaken for melanoma.

Chapter 7: Melanoma In Situ and Herpes [02:11:00]
This chapter presents a case of melanoma in situ, noting its asymmetrical pattern, dense inflammatory infiltrate, and pagetoid spread of melanocytes. It also discusses an incidental finding of herpes simplex virus.

Chapter 8: Acral Melanoma & Desmoplastic Melanoma [02:25:30]
The video covers acral melanoma, which occurs on the palms and soles and is characterized by a chaotic pattern and significant atypia. It then discusses desmoplastic melanoma, a challenging diagnosis known for its deep spindle cells and reliance on S-100 staining.

Chapter 9: BAP1-Inactivated Melanocytic Nevus (BAPoma) [03:13:00]
The final topic is the BAP1-inactivated melanocytic nevus. The video describes this lesion as a nodule of large, epithelioid cells with a loss of BAP1 staining, which is associated with an increased risk of other cancers.

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