lentigo maligna and basal cell carcinoma, same specimen

LENTIGO MALIGNA AND A BASAL CELL CARCINOMA IN THE SAME SPECIMEN

Although not common, one occasionally encounters a lesion within the background of a lentigo maligna that is not directly related. An incidental lesion, such as a carcinoma or even a banal nevus, may account for a papule (palpable focus) in the background of the macular (nonpalpable) lentigo maligna. The palpable focus will often be the site of a biopsy since it would be a palpable area that would most likely be the focus of invasion (melanoma) in the background of a lentigo maligna.

In this particular case, atypical lentiginous melanocytic hyperplasia was noticed in addition to the basal cell carcinoma in the biopsy, and it was suggested that the entire pigmented lesion be excised.

This is a biopsy from the cheek of an elderly man. The clinical diagnosis was 'lentigo, rule out basal cell carcinoma'.

Scan power view. Multiple buds of basaloid epithelium are present in the lower part of the epidermis. Severe solar elastosis is also seen. The lesion is pigmented.

A high power view of one of the buds of epithelium. This shows a pigmented basal cell carcinoma. I cannot tell whether these are atypical melanocytes or ordinary dendritic melanocytes within the basal cell carcinoma.

A high power view from another area. This type of pathology was seen in several foci in this biopsy. Atypical lentiginous melanocytic hyperplasia is present and is strongly suggestive of lentigo maligna.

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	Scan power view. Multiple buds of basaloid epithelium are present in the lower part of the epidermis. Severe solar elastosis is also seen. The lesion is pigmented.
	A high power view of one of the buds of epithelium. This shows a pigmented basal cell carcinoma. I cannot tell whether these are atypical melanocytes or ordinary dendritic melanocytes within the basal cell carcinoma.
	A high power view from another area. This type of pathology was seen in several foci in this biopsy. Atypical lentiginous melanocytic hyperplasia is present and is strongly suggestive of lentigo maligna.