Microscopic Description -- Pigmented Lesion


MICROSCOPIC DESCRIPTION:


Pigmented lesion of the right ear: (a) Low power view, showing markedly increased numbers of variably atypical pleomorphic melanocytes, with large hyperchromatic nuclei, and an enlarged retraction artifact, arranged in solitary units, located along the basal layer in an atrophic epidermis, with periadnexal extension, overlying a lymphocytic infiltrate and melanophages in a papillary dermis manifesting marked solar elastosis (H & E x 100). (b) Higher magnification, showing a disordered proliferation of variably atypical intraepidermal melanocytes arranged in solitary units and a single nest of atypical cells, in an atrophic epidermis, with periadnexal extension, and a sparse lymphocytic infiltrate and melanophages in a papillary dermis with extensive solar elastosis ( H & E x 200). (c) An extensive periadnexal extension by variably atypical pleomorphic melanocytes is seen arranged in solitary units along the basal layer (H & E x 200). (d and e) Low and higher power views of a large multinucleated melanocyte with eosinophilic non-pigmented cytoplasm, located at the basal layer (H & E x 200 & 400). Immunohistochemical staining with S100 and HMB-45 failed to demonstrate microinvasive cells (not shown).


FINAL DIAGNOSIS


Case 

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