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Histologisches Spektrum des malignen Melanoms

Histological spectrum of malignant melanoma

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Zusammenfassung

Die Gruppe der melanozytären Tumoren gehört zu den diagnostisch problematischsten Gebieten in der Dermatologie und Histopathologie. Das Melanom ist ein bösartiger melanozytärer Tumor, dessen Metastasen- und Mortalitätsrisiko hauptsächlich von der Invasionstiefe und Tumordicke bestimmt wird. Eine frühzeitige Erkennung und die korrekte Diagnose sind daher Voraussetzungen für eine erfolgreiche Behandlung. Erschwert wird die Diagnose des Melanoms jedoch durch das breite morphologische Spektrum. Historisch wurde das Melanom in das superfiziell spreitende, das noduläre, die Lentigo maligna und das akral lentiginöse Melanom unterteilt. Über die Jahre sind dieser Unterteilung noch viele andere Melanomvarianten hinzugefügt worden. Neuere Erkenntnisse zeigen, dass einige dieser Untergruppen auch spezifische genetische Veränderungen, klinische Präsentationen, Prognosen und Behandlungen sowie Differenzialdiagnosen aufweisen. Vier dieser klinisch bedeutenden Varianten, nämlich das desmoplastische Melanom, das nävoide Melanom, der maligne blaue Nävus und das pigmentsynthetisierende Melanom, werden in diesem Artikel besprochen.

Abstract

The diagnosis of melanocytic tumors is one of the most problematic areas in dermatology and diagnostic pathology. Melanoma is a malignant melanocytic tumor and the risk for metastasis and associated mortality is mainly dependent on tumor thickness and depth of invasion. Early recognition and correct diagnosis is therefore important for successful and effective treatment. The correct diagnosis of melanoma is, however, challenging due to the wide morphological spectrum. Historically, the disease was subdivided into superficial spreading, nodular, lentigo maligna and acral lentiginous melanoma but many more subtypes have subsequently been added. Some of these melanoma variants also show differences relating to the genetic background, clinical presentation, prognosis and treatment and may be associated with a specific differential diagnosis. In this article four of these melanoma variants, desmoplastic melanoma, nevoid melanoma, malignant blue nevus and pigment synthesizing melanoma will be discussed in more detail.

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Einhaltung ethischer Richtlinien

Interessenkonflikt. T. Brenn gibt an, dass kein Interessenkonflikt besteht Dieser Beitrag beinhaltet keine Studien an Menschen oder Tieren.

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  1. Abteilung für Pathologie, Western General Hospital und University of Edinburgh, Crewe Rd, EH4 2XU, Edinburgh, Schottland

    T. Brenn MD, PhD, FRCPath

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  1. T. Brenn MD, PhD, FRCPath
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Correspondence to T. Brenn MD, PhD, FRCPath.

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Brenn, T. Histologisches Spektrum des malignen Melanoms. Pathologe 36, 53–61 (2015). https://doi.org/10.1007/s00292-014-2001-4

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