Case Number : Case 2722 - 11 December 2020 Posted By: Dr. Richard Carr

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I think there is maturation in this composite melanocytic lesion. The intraepidermal growth shows some basal spreading, but not Pagetoid or epidermal destructive consumption. So my spot is Atypical/Dysplastic Nevus

I think this is a combined nevus, maybe a BAP1-inactivated nevus. It would be nice to see BAP1 and BRAF ihq in this lesion.

58 minutes ago, IgorSC said:

I think this is a combined nevus, maybe a BAP1-inactivated nevus. It would be nice to see BAP1 and BRAF ihq in this lesion.

Usually the Bap1 negative cells, as I know, are large epithelioid cells, and intradermal nodule forming. But I’m happy to share the same benign suggestion with Igor. 

I am also not in favour of melanoma. Atypical/dysplastic nevus or may be BAP1 inactivated. 

Case c/o Dr Brinder "Buzz" Chohan.

My interpretation: Many thanks for the opportunity to review this case. This is a highly junctionally active compound lesion
with slightly enlarged type A melanocytes. Overall relatively good symmetry. Nice chequer board p16 throughout and minimal Ki67 nuclear proliferation. This is a special site naevus with some architectural atypical features as described in younger individuals on the scalp.
Excision appears complete with appropriate margins.

Compound melanocytic nevus, special site.

On 14/12/2020 at 07:58, Dr. Richard Carr said:

Case c/o Dr Brinder "Buzz" Chohan.

My interpretation: Many thanks for the opportunity to review this case. This is a highly junctionally active compound lesion
with slightly enlarged type A melanocytes. Overall relatively good symmetry. Nice chequer board p16 throughout and minimal Ki67 nuclear proliferation. This is a special site naevus with some architectural atypical features as described in younger individuals on the scalp.
Excision appears complete with appropriate margins.

Agree. Thanks Dr Carr.

Scalp nevus can be as "striking" as though "ear" nevus.