By W. J. Mooi MD, T. Krausz MD, MRCPath (auth.)
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Extra info for Biopsy Pathology of Melanocytic Disorders
The anaesthetic just outside the area of skin to be excised; the anaesthesia fluid should never be injected into or in the immediate vicinity of the lesion, since this results in disturbing histological artefacts (Mehregan and Pinkus, 1966; Sagebiel, 1972). g. g. giant congenital naevus containing a suspicious area, or lentigo maligna with Description and dissection of skin biopsy 19 or without a suspected invasive focus), or when the localization is awkward, as is the case with subungual lesions.
P. M. and Bosman, F. T. (1989) Basement membrane deposition in benign and malignant naevo-melanocytic lesions: an immunohistochemical study with antibodies to type IV collagen and laminin. Histopathology, 15, 137-46. Howat, A. , Wright, A. , Cotton, D. W. , Reeve, S. and Bleehen, S. S. (1990) AgNORs in benign, dysplastic and malignant melanocytic skin lesions. Am. f. , 12, 156-61. Inoshita, T. and Youngberg, G. A. (1982) Fluorescence of melanoma cells. A useful diagnostic tool. Am. f. Clin. , 78, 311-5.
However, for this very reason, histopathologists can be lulled into a false sense of security by the absence of pagetoid spread. The absence of pagetoid spread in Spitz naevi helps to distinguish them from superficial spreading melanomas, a point rightly stressed by many authors. However, pagetoid spread is also absent in some 'Spitzoid' spindle cell melanomas which need to be distinguished from Spitz naevus. Many signs of malignancy 'work only one way': if they are present, the lesion is definitely a melanoma, but in their absence the lesion may still be a melanoma.
Biopsy Pathology of Melanocytic Disorders by W. J. Mooi MD, T. Krausz MD, MRCPath (auth.)