77-year-old male with lesion suspicious of melanoma on left thigh
skin spindle with central asymmetrical, poorly demarcated, brown-black, irregularly pigmented, ulcerated lesion, 3 cm in diameter.
- Asymmetrical neoplasia, junctional and dermal with poor lateral demarcation
- Large confluent cell nests, distinct cell and nuclear polymorphism, enlarged hyperchromatic cell nuclei, no maturation; evidence of mitoses
- Epidermis partly pagetoid infiltrated , partly ulcerated
- There is evidence of vertical growth tendency and development of a node.
- Infiltration of stratum reticulare, corresponding to Clark level IV, the maximal vertical Breslow thickness is 3.7 mm.