Melanocytic lesions - Staying out of trouble

The diagnosis of melanocytic tumors is notoriously difficult and represents one of the most challenging areas in surgical pathology associated with significant risk for litigation. One reason is the wide morphologic spectrum of melanocytic tumors and the fact that many histological features are shared by both benign melanocytic nevi and melanoma. Awareness of the many morphologic variations and variants of nevi and melanoma, their clinical setting, immunohistochemical phenotype and genetic profile is necessary for the correct diagnosis. The article discusses the features of three variants of melanoma, desmoplastic, acral lentiginous and vulvar mucosal lentiginous melanoma, and their benign melanocytic mimics with emphasis on distinguishing features.