Melanoma, malignant, superficially spreading: Exceptionally large, 8.0x4.0 cm in diameter, regressive, completely asymptomatic malignant melanoma of the SSM type. No bleeding, no oozing. The late visit to the doctor was inexplicable after about 20 years (photo comparisons possible) of growth. The patient carefully clothed the melanoma-bearing area during free exposure to the sun. See: Pigmentation of the central back areasstill slightly tanned after sun exposure.
Melanoma, malignant, superficially spreading.superficially spreading malignant melanoma with multiple, partly inconspicuous, partly dysplastic melanocytic nevi. over decades, regular, intensive sun exposure in southern European countries ("he just loves the sun").
Melanoma, malignant, superficially spreading: superficially spreading malignant melanoma. reflected light microscopy of the previous image. irregular pigment network with focal pseudopodia. central: hyper and hypopgimentation.
Melanoma superficially spreading: Plaque which is no longer symmetrical and smooth on the surface with several elongated growth zones which break through the contours of the edges, see further detailed images.
melanoma, superficially spreading: no longer symmetrical, surface-smooth plaque with several elongated growth zones (arrows) which break up the contours of the edges. encircles a blurredly limited depigmentation zone. hyperpigmented area marked by a square.
Melanoma malignant, superficially spreading: reflected-light microscopy of the marginal zone; indicated irregular reticular str-infiltrate structures at the lower right edge of the image, white-grey, blurredly limited brightening zone (superficial loss of pigment, extensive inflammatory infiltrates)
melanoma, malignant, superficially spreading. incident light microscopy: marginal area, Clark level III, TD 0.7 mm. peripheral light brown reticular pigment pattern, centropapillary brown "dots". in the image area on the right, grey, unstructured area. signs of malignancy with deeper lying pigment and inflammatory infiltrates.
Melanoma malignant superficially spreading: Exceptionally large, 6.0x4.0 cm in diameter, malignant melanoma of the SSM type with nodular part. No bleeding, no oozing. The patient carefully clothed the melanoma-bearing area when exposed to the sun.
Melanoma superficially spreading: extraordinarily large, 6.0x4.0 cm in diameter, malignant melanoma of the SSM type with a nodular, largely amelanotic part; here evidence of bizarre vessels.
Melanoma malignes superficially spreading: pigmentation mark known and growing for years. No subjective complaints. The melanoma grows asymmetrically (no axial symmetry) with irregular pigmentation and depigmentation zones.
Melanoma malignes superficially spreading: pigmentation mark known and growing for years; no subjective complaints; the melanoma grows asymmetrically (no axial symmetry; growth zone marked by a square) with irregular pigmentation and depigmentation zones (encircled)
Melanoma malignant superficially spreading: Incident light microscopic image with irregular pigment network, irregular black-brown pigment conclusions, white-grey brightening zones. irregular overall pattern, see following figure.
Melanoma superficially spreading: reflected-light microscopic image with irregular pigment network (encircled) irregular black-brown pigment deposits, white-grey brightening zones (marked by a square). irregular overall pattern.
Melanoma superficially spreading: reflected-light microscopic image with an irregular pigment network clearly protruding at the edges, irregular black-brown pigment deposits, white-grey brightening zones, irregular overall pattern.
Melanoma, malignant, superficially spreading, deep black tumor with radial streaming and pseudopodial border zone and central atrophy.
Melanoma, malignant, superficially spreading papule in a 66-year-old woman, since several years pretibially localized on the left side, slowly progressive in size, inhomogeneously brownish-blackish colored, with partly fine-lamellar scaling.
Melanoma, malignant, superficially spreading, irregularly limited and pigmented plaque with distal nodular part.
Melanoma, malignant, superficially spreading. 2.0 x 1.4 cm large, brown-black to black plaque with nodular parts and irregular borders on clearly sun-tanned skin. Within the plaque two smaller, reddish-brown areas are also impressive. The lesion has occasionally bled in the history (trace of blood when drying).
Melanoma, malignant, superficially spreading. irregularly bordered, brownish-black, partly only slightly raised, partly clearly raised plaque on the right shoulder of a 39-year-old man, measuring about 1 cm in diameter. peripherally there is a horseshoe-shaped, dark brown part, in the centre there is a white, regressive part. incident light microscopy: pseudopodia, grey haze.
Melanoma, malignant, superficially spreading, since 2 years existing, slowly progressing in size, pectoralized on the right side, measuring 1.7 x 1.3 cm, inhomogeneously pigmented, sharply but irregularly limited, black-greyish to bluish plaque.
Melanoma, malignant, superficially spreading. reflected light microscopy: Inhomogeneous, black-greyish-bluish pigmented, sharp but irregularly defined plaque with widened reticular ridges and irregular netting meshes. The outer line with streaky, bud-like extensions is characteristic of malignancy.
Melanoma, malignant, superficially spreading. reflected light microscopy, detail magnification: Distinct, brown-black pigment network with veil-like blue-grey insertions; pseudopodia and radial streaming are clearly visible
Melanoma, malignant, superficially spreading. 1.2 x 0.8 cm in size, slowly progressive for 3 years, irregularly limited, black, slightly raised plaque with a partly bumpy surface, localized in the neck of a 73-year-old man. The surrounding area (regression zone) is reddish-livid discolored.
Melanoma, malignant, superficially spreading. regressive SSM: Irregularly limited, light brown to brownish, partly orange-brown or blackish, slightly raised plaque without accentuating the edges. the melanoma developed within a scar, 2 years after excision of a melanocytic nevus. TD: 0.55 mm.
Melanoma, malignant, superficially spreading, solitary, slowly growing, irregularly shaped, partly reddish to reddish-brownish, shiny, approx. 2 x 3 cm plaque located on the left breast.
Melanoma, malignant, superficially spreading, irregularly limited and black-brown discolored pigment tumor with regression zone on the right side (blown off part) and centrally located, surface-eroded, nodular part (tumor thickness: 4.2 mm).
Melanoma, malignant, superficially spreading, paralabially localized on the left side, measuring about 2 x 2.5 cm, irregularly limited, centrally reddish depigmented, peripherally brown-black hyperpigmented macula with raised rim in a 77-year-old female patient.
melanoma, malignant, superficially spreading. incident light microscopy: marginal area, Clark level III, TD 0.7 mm. peripheral light brown reticular pigment pattern, centropapillary grey globules. in the lower image area on the right, grey-blueish unstructured area. signs of malignancy with deeper pigment and inflammatory infiltrates. upper margin: parts of the melanocytic nevus with signs of severe dysplasia (beginning loss of reticular structure)
Melanoma, malignant, superficially spreading. reflected light microscopy: marginal area, Clark level II-III, TD 0.35 mm. peripheral light brown reticular pigment pattern.
melanoma, malignant, superficially spreading. superficially spreading malignant melanoma. initial transformation from a melanocytic nevus. parts of the nevus detectable on the right side of the picture. signs of dysplasia in the lower part of the picture. on the left side of the picture distinct melanoma development with radial (inorganic) extensions of the malignant melanoma established here.
Melanoma, malignant, superficially spreading. 20 MHz sonography: Echo-free zone below the broad entrance echo.
Melanoma, malignant, superficially spreading. marginal area of the tumor: Pagetoid penetration of the lower and middle parts of the surface epithelium by atypical melanocytes. irregular pigment distribution (see middle sections).
Melanoma, malignant, superficially spreading. irregular epidermal hyperplasia, atypical melanocytes in nests and single cell formations in all epidermal layers. broad dermal infiltration; strong lymphocytic infiltrate at the base of the tumor
melanoma, malignant, superficially spreading. detail enlargement: irregular acanthosis with the previously described melanocyte proliferation rates. at the picture margin left middle (middle dermis), circumscribed nests with melanophages. at the lower edge of the picture elongated age-cut sweat gland duct. strong lymphocytic infiltrate at the tumor base.
Melanoma, malignant, superficially spreading. further detail enlargement: distinct polymorphism of the melanocytes. numerous mononuclear and multinuclear tumor giant cells.
Melanoma, malignant, superficially spreading. Further detail enlargement from the lateral tumor section: Pagetoid penetration of the surface epithelium by atypical melanocytes which occur in nests but also in single formations. In the picture on the right side, lower corner, remains of a follicle with complete tumor penetration.
Melanoma, malignant, superficially spreading. immunohistology (MART): Diffuse penetration of surface and deep epithelium by MART-positive tumor proliferates; stranded infiltration of the upper and middle dermis.
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