Kwittken J
Division of Dermatology, UMDNJ-New Jersey Medical School, Newark 07103.
J Med. 1991;22(1):1-16.
Melanocytic dysplasia refers not only to a variety of histologic changes, but is also a histologic diagnosis. Melanocytic dysplasia represents a diagnosis for those lesions in which the biologic potential cannot be determined. Histologic differences between a diagnosis of melanocytic dysplasia and malignant melanoma are detailed. The terms: borderline malignant melanoma or lesion, precancerous melanosis, active or activated nevus and atypical melanocytic hyperplasia should be abandoned. A differential diagnosis between in situ malignant melanoma and other melanin-containing in situ malignancies has been presented. All types of malignant melanoma which originate within the epidermis or epithelium have an in situ phase and show horizontal growth, and small early forms defy classification. The classification of the most common types of malignant melanoma has been revised. Although the level of invasion and tumor thickness are useful prognostic and therapeutic parameters, their determination is crude and subject to several shortcomings.
黑素细胞发育异常不仅指多种组织学变化，也是一种组织学诊断。黑素细胞发育异常是针对那些生物学潜能无法确定的病变的诊断。详细阐述了黑素细胞发育异常诊断与恶性黑色素瘤之间的组织学差异。“交界性恶性黑色素瘤或病变”“癌前黑变病”“活性或活化痣”以及“非典型黑素细胞增生”等术语应摒弃不用。已介绍了原位恶性黑色素瘤与其他含黑色素原位恶性肿瘤之间的鉴别诊断。所有起源于表皮或上皮内的恶性黑色素瘤类型都有原位期并呈水平生长，早期小病灶难以分类。最常见的恶性黑色素瘤类型的分类已修订。尽管浸润深度和肿瘤厚度是有用的预后和治疗参数，但它们的测定方法粗略且存在若干缺点。
