Department of Pathology and Dermatology, MD Anderson Cancer Center, University of Texas, Houston, 77030, USA.
Adv Anat Pathol. 2012 Jul;19(4):263-9. doi: 10.1097/PAP.0b013e31825c6be2.
Of all pathology fields, the analysis of melanocytic lesions has one of the highest rates of review for legal reasons, particularly regarding the distinction between nevus and melanoma. Among the most frequently involved are desmoplastic melanoma, nevoid melanoma, and Spitz nevus versus spitzoid melanoma. Therefore, it follows that pathologists and dermatopathologists should pay special attention when dealing with such type of lesions. This review article will emphasize a number of clinical, histologic, and immunohistochemical features we believe are essential when evaluating lesions whose differential diagnosis includes melanoma/nevus. Furthermore, we want to stress the importance of examining the entire slide within the context of all available information in order to not miss the invisible gorilla in the slide. Regarding this apparently bizarre choice to illustrate these problems (to not miss an invisible gorilla), we request the reader to continue reading this article to find out why.
在所有病理学领域中,由于法律原因,黑素细胞病变的分析审查率最高,尤其是在区分痣和黑色素瘤方面。最常涉及的病变包括促结缔组织增生性黑色素瘤、结节性黑色素瘤和 Spitz 痣与 Spitz 样黑色素瘤。因此,病理学家和皮肤病理学家在处理此类病变时应特别注意。本文将强调一些临床、组织学和免疫组织化学特征,我们认为这些特征对于评估包括黑色素瘤/痣在内的病变的鉴别诊断至关重要。此外,我们还强调了在检查整个切片时,必须结合所有可用信息的重要性,以免错过切片中无形的大猩猩。关于选择这个看似奇怪的例子来阐述这些问题(为了不错过无形的大猩猩),我们请读者继续阅读本文,以了解原因。