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 exam worthy q -3  

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11. A 2.1-cm, pigmented lesion is excised from the back
of a 39-year-old female, who noticed that this lesion has
become more nodular in appearance within the past 2
months. Microscopic examination of this lesion reveals a
malignant melanoma, composed of epithelioid cells, that
extends 2 mm down to the reticular dermis. There is a
band of lymphocytes beneath the melanoma. Which of the
following statements is most appropriate to make to this
O (A) Your body's immune system will prevent metasta-
O (B) The prognosis is poor.
O (C) Other family members are at risk for this condition.
O (D) The primary site for this lesion is probably the eye.
O (E) Nevi elsewhere on your body may become malig-






11. (B) Extension deep into the reticular dermis is indica-
tive of vertical (nodular) growth. When a melanoma exhib-
its a nodular growth pattern, rather than a radial pattern,
there is a high likelihood that a clone of neoplastic cells
has arisen that is more aggressive and is more likely to
metastasize. Although there is a lymphocytic response to
this tumor, it is not sufficient to destroy or contain it
completely. Most melanomas are sporadic, nonfamilial, and
related to sun exposure. Melanomas of the eye are much
less common than melanomas of the skin. Benign skin nevi
do not have a tendency to become malignant.

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