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Cutaneous Melanocytic Lesions: Do Not Miss the Invisible Gorilla

Prieto, Victor G. MD, PhD

Advances in Anatomic Pathology: July 2012 - Volume 19 - Issue 4 - p 263–269
doi: 10.1097/PAP.0b013e31825c6be2
Review Articles

Of all pathology fields, the analysis of melanocytic lesions has one of the highest rates of review for legal reasons, particularly regarding the distinction between nevus and melanoma. Among the most frequently involved are desmoplastic melanoma, nevoid melanoma, and Spitz nevus versus spitzoid melanoma. Therefore, it follows that pathologists and dermatopathologists should pay special attention when dealing with such type of lesions. This review article will emphasize a number of clinical, histologic, and immunohistochemical features we believe are essential when evaluating lesions whose differential diagnosis includes melanoma/nevus. Furthermore, we want to stress the importance of examining the entire slide within the context of all available information in order to not miss the invisible gorilla in the slide. Regarding this apparently bizarre choice to illustrate these problems (to not miss an invisible gorilla), we request the reader to continue reading this article to find out why.

Departments of Pathology and Dermatology, MD Anderson Cancer Center, University of Texas, Houston, TX

The author has no funding or conflicts of interest to disclose.

Reprints: Victor G. Prieto, MD, PhD, Departments of Pathology and Dermatology, MD Anderson Cancer Center, University of Texas, 1515 Holcombe Blvd., Unit 85, Houston, TX 77030 (e-mail: vprieto@mdanderson.org).

All figures can be viewed online in color at http://http://www.anatomicpathology.com.

Copyright © 2012 Wolters Kluwer Health, Inc. All rights reserved.