Staging for Specimens of Malignant Melanoma of Skin

 pT1a: Melanoma ≤ 1.0 mm, no ulceration, no mitoses


image pT1b: Melanoma ≤ 1.0 mm, with ulceration &/or mitoses (≥ 1/mm²)


• pT2: Melanoma > 1.0 – 2.0 mm in thickness
image pT2a: Melanoma > 1.0 – 2.0 mm, no ulceration

image pT2a: Melanoma > 1.0 – 2.0 mm, with ulceration

• pT3: Melanoma greater than 2.0-4.0 mm in thickness
image pT3a: Melanoma > 2.0 – 4.0 mm, no ulceration

image pT3a: Melanoma > 2.0 – 4.0 mm, with ulceration

• pT4: Melanoma greater than 4.0 in thickness
image pT4a: Melanoma > 4.0 mm, no ulceration

image pT4a: Melanoma > 4.0 mm, with ulceration

• pNX: Regional lymph nodes cannot be assessed

• pN0: No regional lymph node metastasis

• pN1: Metastasis to 1 regional lymph node
image pN1a: Clinically occult metastasis (micrometastasis)

image pN1b: Clinically apparent metastasis (macrometastasis)

• pN2: Metastasis in 2-3 regional lymph nodes or intralymphatic regional metastasis without nodal involvement
image pN2a: Clinically occult metastasis (micrometastasis)

image pN2b: Clinically apparent metastasis (macrometastasis)

image pN2c: Satellite or in-transit metastasis without nodal metastases

• pN3: Metastasis in 4 or more regional lymph nodes, or matted lymph nodes, or in-transit or satellite metastases with positive regional nodes

• pM1 (required only if there is confirmed metastasis)
image pM1a: Metastasis to skin, subcutaneous tissue, or distant lymph node(s)

image pM1b: Metastasis to lung

image pM1c: Metastasis to all other visceral sites or distant metastasis associated with elevated serum LDH levels
– Specify site:____




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Melanoma In Situ (Tis)
Tis melanoma is a melanoma in situ with no evidence of dermal invasion.


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Metastatic Melanoma on PET/CT Scan
Axial fused PET/CT in a patient with melanoma shows intense FDG activity image in a lesion in the right posterior neck musculature, consistent with metastatic disease (M1a).


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T1a Invasive Melanoma
T1a invasive melanoma shows a tumor with superficial invasion image ≤ 1.0 mm in thickness, without ulceration or evidence of dermal mitotic activity.

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T1b Invasive Melanoma
T1b invasive melanoma shows a tumor invasive image ≤ 1.0 mm in thickness, with ulceration image &/or evidence of dermal mitotic activity (≥ 1/mm²). T1b tumors are clinically more aggressive and have a higher incidence of metastasis than T1a tumors.

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T2a Invasive Melanoma
T2a melanoma invades to > 1.0 mm in thickness image, but is ≤ 2.0 mm in depth, and lacks evidence of ulceration.

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T2b Invasive Melanoma
T2b melanoma invades to > 1.0 mm in thickness image, but is ≤ 2.0 mm in depth, and shows evidence of ulceration image. Ulceration is one of the worst prognostic findings.

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T3a Invasive Melanoma
T3a melanoma invades to > 2.0 mm in thickness, but is ≤ 4.0 mm in depth, and lacks evidence of ulceration.

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Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Staging for Specimens of Malignant Melanoma of Skin

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