Department of Pathology, Baylor College of Medicine, Houston, Texas, USA.
Arch Pathol Lab Med. 2011 Jul;135(7):838-41. doi: 10.5858/2011-0051-RAIR.1.
Cutaneous primary invasive malignant melanoma often is classified by its histologic appearance. Major recognized histologic subtypes of melanoma include superficial spreading, lentigo maligna melanoma, nodular, and acral lentiginous. More recently, it has been shown that most primary invasive melanomas harbor nonrandom genetic or biochemical aberrations that correlate with anatomic site or with the amount of cutaneous exposure to sunlight. It also is generally accepted that most primary invasive melanomas are preceded by an intraepidermal atypical melanocytic proliferation that lacks invasive capability (melanoma in situ).
To focus on lentigo maligna, the preinvasive/in situ form of melanoma located on chronically sun-damaged skin.
Review of the literature and the authors' personal experiences.
A better understanding of the earliest stage of melanoma progression, including the contribution of chronic exposure to ultraviolet radiation, may lead to improved classification schemes that direct more effective targeted or personalized therapies for patients.
皮肤原发性浸润性恶性黑色素瘤通常根据其组织学表现进行分类。公认的黑色素瘤主要组织学亚型包括浅表扩散型、恶性雀斑样痣黑素瘤、结节型和肢端雀斑样黑素瘤。最近，已经表明大多数原发性浸润性黑色素瘤存在非随机的遗传或生化异常，这些异常与解剖部位或皮肤暴露于阳光的程度相关。人们普遍认为，大多数原发性浸润性黑色素瘤是由缺乏侵袭能力的表皮内非典型性黑色素细胞增殖引起的（原位黑色素瘤）。
重点关注位于慢性日光损伤皮肤上的侵袭前/原位形式的恶性雀斑样痣黑色素瘤。
文献复习和作者的个人经验。
更好地了解黑色素瘤进展的最早阶段，包括慢性暴露于紫外线辐射的贡献，可能会导致改进的分类方案，为患者提供更有效的靶向或个性化治疗。
