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J Clin Pathol 58:453-456 doi:10.1136/jcp.2004.019422
  • Review

Melanocytic dysplastic naevi occupy the middle ground between benign melanocytic naevi and cutaneous malignant melanomas: emerging clues

Table 1

 Summary of the morphological, immunohistochemical, and molecular features of melanocytic skin lesions

Feature BN MDN Early CMM Refs
BN, benign naevi; CMM, cutaneous malignant melanoma; MDN, melanocytic dysplastic naevi; MMR, mismatch repair; MSI, microsatellite instability; TSG, tumour suppressor gene.
Clinical
    Symmetry Symmetrical Asymmetrical Asymmetrical 5–8, 9
    Size Small (<5 mm) Larger (>5 mm) Variable 5–8, 9
    Border Regular Irregular Irregular 5–8, 9
    Colour Uniform Variegated Variegated 5–8, 9
Histological
    Cytological atypia Absent Mild to severe Severe 5–8, 9
    Architectural atypia Absent Mild to severe Severe 5–8, 9
Ultrastructural
    Melanosomes Normal Aberrant Aberrant 10, 11
    Golgi Normal Well developed Well developed 10, 11
    Mitochondria Numerous Abundant Abundant 10, 11
Immunohistochemical
    MMR protein expression Strong Intermediate Decreased 12
    p53, HMB45 expression Absent Intermediate Pronounced 13, 14
    Proliferation marker expression Low Intermediate High 15–17
Genetic
    MSI Absent/Present Present (+) Present (+++) 18, 19
    Allelic loss Absent Present (+) Present (+++) 20–22
    Loss of TSG (p16 and p53) Absent Present (+) Present (+++) 23
    Alterations of oncogenes (ras) Absent Present (+) Present (+++) 24

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