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Pagetoid melanocytosis: tease or tocsin?

J B Stern1, H M Haupt

  • 1Laboratory of Pathology, National Institutes of Health, Bethesda, MD, USA.

Seminars in Diagnostic Pathology
|August 26, 1998
PubMed
Summary

Pagetoid melanocytosis (PM), the upward spread of melanocytes in the epidermis, is common in melanoma but also found in benign nevi. Distinguishing features help differentiate melanoma from benign lesions.

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Area of Science:

  • Dermatopathology
  • Histopathology
  • Melanoma Research

Background:

  • Pagetoid melanocytosis (PM) is a histological term for melanocyte extension into the epidermis.
  • Previously termed pagetoid scatter/spread, PM requires precise definition.
  • PM is observed in both malignant melanoma and benign melanocytic nevi.

Purpose of the Study:

  • To define Pagetoid Melanocytosis (PM) histologically.
  • To identify features distinguishing PM in melanoma from benign lesions.
  • To clarify the diagnostic significance of PM in melanocytic lesions.

Main Methods:

  • Histological examination of melanocytic lesions.
  • Identification and characterization of pagetoid melanocytosis.
  • Analysis of features associated with malignant melanoma versus benign nevi.

Main Results:

  • Pagetoid melanocytosis (PM) occurs in approximately 76% of malignant melanomas.
  • PM is also a frequent finding in various benign melanocytic nevi.
  • Features favoring melanoma include diffuse/dense spread, atypia, and free-floating PM.

Conclusions:

  • Pagetoid melanocytosis (PM) is a significant histological finding in melanocytic lesions.
  • While PM is common in melanoma, its presence alone does not confirm malignancy.
  • Pathologists must consider all histological and clinical data for accurate diagnosis.

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