However, mimics of melanoma (eg, pagetoid
Spitz nevus, spindle cell nevus of Reed) should be carefully considered before a small lesion is diagnosed as melanoma.
With respect to internal structure most COD cases were reported to be in the mixed radiolucent/ radiopaque stage and the internal radiopacities were described as being either one or a mixture of cementum-like ground glass or "Pagetoid
" (a term used mostly in the description of extensive radiopacities in florid COD cases).
Breadth is important because showing the pathologist the epidermis (especially the edge) of a suspected melanocytic tumor allows for detection of pagetoid
spread (upward movement through the epidermis) of melanocytes and of single melanocytes at the edge of a tumor.
Biopsy of the scalp lesion (Figure 4) revealed prominent intraepidermal atypical melanocytes with pagetoid
spread, as well as the presence of well-formed junctional melanocytic nests, characteristic for malignant melanoma with superficial spreading pattern and stained positive for S-100 and S0X-10.
The diagnosis of pagetoid
Bowen's disease (BD) is definite.
The parameters evaluated by microscope include assessment of the following: presence of absence of melanocytes in the tumor (melanocytic or non-melanocytic tumor); cell morphology (epithelioid, spindle, plasmacytoid or mixed); form of cell organization (solid, alveolar, organoid or pagetoid
); presence of necrosis, and perineural and perivascular invasion; and depth of tumor invasion, cell invasion according to the criteria of Prasad et al.
Ameer, "Nevus lipomatosus cutaneous superficialis with focal lipocytic pagetoid
epidermal spread and secondary calcinosis cutis: A case report," American Journal of Dermatopathology, vol.
spread nor mitotic activity could be observed.
Giant-cell lesions can be present in Paget's disease, but in this case there was no sign of pagetoid
There was focal pagetoid
involvement of the overlying squamous mucosa (Figure 2).
Patients with pagetoid
bone may be predisposed to the development of arthritis as demonstrated by Altman (5) who proposed that bony enlargement may reduce joint space.
Dans, "Syringocystadenocarcinoma papilliferum in situ with pagetoid
spread: a case report," Histopathology, vol.