Mitotic and amitotic cell replication in malignant melanoma: the role of subdivisional cell replication

It is widely assumed that significant mitotic activity is typical of malignant melanoma and many believe that significant mitotic activity is essential for this diagnosis. We have studied mitotic activity in 205 malignant melanomas and have found that mitotic activity is often minimal or absent, even in malignant melanomas which have recurred or metastasized. Based on our previous work suggesting that new cells can form from nucleoli via nucleolar stalks, we also studied nucleolar stalks in our cases. These were present in greater numbers than mitoses and help explain the anomaly of infrequent mitoses in a highly malignant neoplasm.