The current World Health Organization classification of conjunctival melanocytic proliferations divides them into conjunctival nevi and invasive @entity320 but, in contrast to other anatomic sites, does not recognize @entity320 in situ. All atypical intraepithelial conjunctival proliferations are included in a heterogeneous category designated as primary acquired @entity1709 (PAM) with atypia. We performed clinicopathologic analysis of 29 cases of PAM with atypia. On the basis of histologic features and frequency of association with invasive @entity320 and @entity3 , we were able to divide our cases into 2 histologic groups. The low-risk group (13 cases) included lesions composed of small to medium size melanocytes with high nuclear to cytoplasmic ratio and small to medium size hyperchromatic nuclei devoid of nucleoli showing predominantly single cell lentiginous growth pattern. @entity320 occurred in only 2 cases from this group. None of these lesions metastasized. The second, high-risk group (16 cases), showed increased frequency of association with invasive @entity320 (15/16 cases, 94%) and @entity3 (4/16 cases, 25%). These lesions were more heterogeneous architecturally but were all composed of melanocytes showing various degrees of epithelioid features such as abundant cytoplasm, vesicular nuclei, or prominent nucleoli. In 4 cases discrete areas showing high-risk and low-risk features were identified. All 4 lesions were associated with invasion. Our findings offer a practical approach for prognostically useful subclassification of PAM with atypia, which emphasizes cytologic features of intraepithelial conjunctival melanocytic proliferation.

Low-risk and high-risk histologic features in conjunctival primary acquired XXXX with atypia: Clinicopathologic analysis of 29 cases.

@entity1709 :: ('MESH:D008548', 'Disease') :: ['melanosis'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma', 'Invasive melanoma'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastases']
@entity1709 :: (MESH:D008548,Disease) :: ['melanosis']
