These pictures are of a specimen obtained about one year later of the same lesion depicted in figures A1-A5.  The current specimen shows evidence of progressive neoplasia. The lesion in this specimen is pandermal and involves margins of resection.

The lesion is more cellular at this time, and fascicular patterns at the dermal-epidermal interface are more prominent.

fig. B1

Cytologic atypia is marked, and there is an occasional mitotic figure. High power of above.

fig. B2


fig. B3

The fascicular patterns in figures B1, B2 and B3 add a new dimension to the pathology.They have neuroid qualities and are of a type which often anticipates the appearance of a neurotropic component. The lavender cytoplasm of the neoplastic cells is often a feature of desmoplastic and neurotropic melanomas in the late stages of their evolution.


Atypical spindle and stellate cells are individually isolated among collagen bundles. The pattern of the collagen bundles shows increased complexity. Tissue mucin is slightly increased.

fig. B4

Tumor cells are immunoreactive for S-100. The HMB-45 reaction was negative.

fig. B5

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