The utility of dermoscopy-guided histologic sectioning for the diagnosis of melanocytic lesions: A case-control study - 15/05/16
Abstract |
Background |
Dermoscopy allows for visualization of morphologic structures beyond the epidermis, including features that may indicate early malignant transformation. However, dermoscopic features are rarely considered during routine histologic sectioning, and areas of clinical concern may be missed during microscopic evaluation.
Objective |
We assessed the diagnostic impact of a dermoscopy-guided micropunch score for the evaluation of melanocytic lesions.
Methods |
In this case-control study, we evaluated 150 scored melanocytic lesions. Original tissue specimens were reprocessed to create a control group, in which a new score was introduced elsewhere in the lesion to guide an alternative plane of section. Slides were reviewed in a randomized, double-blinded manner to assess histologic features and render a diagnosis. Dermoscopy was also reviewed.
Results |
The proportion of cases with a higher grade in the original, dermoscopy-guided section was statistically significant. Four invasive melanomas were exclusively identified using the scoring protocol. The presence of regression structures, negative pigment network, radial streaming or pseudopods, and irregular blotches were highly specific for a higher diagnostic grade.
Limitations |
This study is retrospective and reprocessing tissue does not perfectly mimic routine sectioning.
Conclusion |
Dermoscopy can identify important, histologically high-grade areas, and this information can be used to optimize the sectioning of melanocytic neoplasms.
Le texte complet de cet article est disponible en PDF.Key words : biopsy, dermoscopy, diagnosis, histology, melanocytic neoplasms, melanoma
Plan
| Ms Merkel and Dr Amin contributed equally to this article. |
|
| Supported by the IDP Foundation. |
|
| Disclosure: Dr Rademaker served on the advisory board of Georgetown University Cancer Center, as an instructor for the American Association of Cancer Research, and as a consultant for the National Institutes of Health and Journal of the American Medical Association and received honoraria for this. Dr Martini served on the advisory board of Dove-Unilever and received honoraria for this. Dr Gerami served as a consultant to Castle Biosciences Inc, Myriad Genetics, and DermTech Inc, and received honoraria for this. Ms Merkel, Dr Amin, Ms Lee, Dr Yazdan, and Dr Guitart have no conflicts of interest to declare. |
Vol 74 - N° 6
P. 1107-1113 - juin 2016 Retour au numéro
Article précédent
- Standardization of terminology in dermoscopy/dermatoscopy: Results of the third consensus conference of the International Society of Dermoscopy
- Harald Kittler, Ashfaq A. Marghoob, Giuseppe Argenziano, Cristina Carrera, Clara Curiel-Lewandrowski, Rainer Hofmann-Wellenhof, Josep Malvehy, Scott Menzies, Susana Puig, Harold Rabinovitz, Wilhelm Stolz, Toshiaki Saida, H. Peter Soyer, Eliot Siegel, William V. Stoecker, Alon Scope, Masaru Tanaka, Luc Thomas, Philipp Tschandl, Iris Zalaudek, Allan Halpern
- Concordance of handheld reflectance confocal microscopy (RCM) with histopathology in the diagnosis of lentigo maligna (LM): A prospective study
- Tyler D. Menge, Brian P. Hibler, Miguel A. Cordova, Kishwer S. Nehal, Anthony M. Rossi
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement.
Déjà abonné à cette revue ?