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Description This chapter describes the dermoscopy correlation of globules
Author(s) Oriol Yélamos
Responsible author Oriol Yélamos→ send e-mail
Status open
Status update March 1, 2023
Status by Ralph Braun

Definition[edit | edit source]

Globular pattern schematic.jpg

Globules are round to oval well-demarcated structures larger than 0.1mm[1]. They can be aggregated or located along the periphery of a melanocytic lesion (Kittler et al., 2016a). On histologic evaluation brown or black globules correspond to nests of melanocytes located at the epidermis or DEJ.



Globules histology.jpg

Blue Globules[edit | edit source]

Blue globules represent melanocytic nests situated in the dermis [2].

White Globules[edit | edit source]

White globules correspond to melanocytes undergoing balloon cell changes [3].

Peripheral Globules[edit | edit source]

Distribution of globules is important: globules along the periphery of a melanocytic lesion reveal a horizontal growing phase, which can occur either in a growing nevus or in a superficial spreading melanoma.

Irregular Globules[edit | edit source]

In melanoma, globules vary in size, shape and color, and can be frequently found focally and irregularly at the periphery of the lesion [2].

Irregular globules and dots.jpg

Globules in BAP1-inactivated melanocytic tumors (BIMT, BAPOMA[edit | edit source]

However, irregular pigmented globules located eccentrically at the periphery of a raised, otherwise homogeneous melanocytic lesion may raise suspicion for a BAP1-inactivated melanocytic tumor (BIMT), also known as Wiesner nevus or “bapoma” [3].BIMT are a special subset of melanocytic lesions which have two components histologically: a more banal-looking population which corresponds to the globular component located at the periphery, plus an atypical spitzoid population which has a loss of expression of BAP1 and corresponds to the homogenous area of the lesion. Multiple BIMT have been associated with a cancer syndrome with increased risk for uveal melanoma, cutaneous melanoma, mesothelioma, renal cell carcinoma, among others (Wiesner et al., 2012, 2011).

  1. Yélamos et al.: Dermoscopy and dermatopathology correlates of cutaneous neoplasms. J Am Acad Dermatol 2019;80:341-363. PMID: 30321581. DOI.
  2. 2.0 2.1 Woltsche et al.: Abundance of the benign melanocytic universe: Dermoscopic-histopathological correlation in nevi. J. Dermatol. 2017;44:499-506. PMID: 28447347. DOI.
  3. 3.0 3.1 Jaimes et al.: White globules correlate with balloon cell nevi nests. J. Am. Acad. Dermatol. 2011;65:e119-e120. PMID: 21920229. DOI.
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