Médecine

Paramédical

Autres domaines


S'abonner

A comparison of touch imprint cytology and Mohs frozen-section histology in the evaluation of Mohs micrographic surgical margins - 02/09/11

Doi : 10.1067/mjd.2001.112216 
Scott R. Florell, MDa, Lester J. Layfield, MDb, John W. Gerwels, MDa
Salt Lake City, Utah 
From the Departments of Dermatologya and Pathology,b University of Utah Health Sciences Center 

Abstract

Background: Touch imprint cytology (TIC) is commonly used in the diagnosis of tumors and has been applied to margin analysis of breast lumpectomy specimens with good success.

Objective: Our purpose was to determine the diagnostic adequacy of TIC for identifying positive and negative Mohs surgical margins for basal cell carcinoma (BCC) excisions, compared with the “gold” standard, Mohs tangential sectioning.

Methods: Fifty-eight patients undergoing 69 Mohs micrographic surgical procedures for biopsy-proven BCC were included in this study between October 1998 and January 1999. Patients were excluded if the neoplasms were of another histologic type, including BCCs with squamous features. One hundred sixty-six touch imprint slides were prepared from 166 fragments of skin tissue excised during MMS. Touch imprint slides were evaluated blindly and independently by two pathologists, one of whom was also a cytopathologist. The slides were diagnosed as positive for tumor, negative for tumor, or, rarely, atypical but suspect for tumor. Discrepancies between the pathologists' interpretations were re-evaluated with the use of a two-headed microscope and a consensus was reached. After all cytologic interpretation was completed, the results were compared with the histologic diagnosis rendered for each fragment of tissue by the Mohs surgeon.

Results: The prevalence of a positive margin by histologic confirmation was 55% overall, 60% for recurrent or sclerosing lesions, and 51% for nonsclerosing or recurrent lesions. The overall accuracy of this technique in identifying true positive and true negative margins was 71%. The sensitivity of TIC for identifying a positive margin was approximately 50% for all BCC types. The specificity was approximately 90% for all BCC types.

Conclusion: TIC is inadequate for identifying positive margins compared with the “gold” standard, MMS. (J Am Acad Dermatol 2001;44:660-4.)

Le texte complet de cet article est disponible en PDF.

Plan


 Reprint requests: Scott R. Florell, MD, Department of Dermatology, University of Utah Health Sciences Center, 50 N Medical Dr, Salt Lake City, UT 84132. E-mail: scott@derm.med.utah.edu.
 J Am Acad Dermatol 2001;44:660-4


© 2001  American Academy of Dermatology, Inc. Publié par Elsevier Masson SAS. Tous droits réservés.
Ajouter à ma bibliothèque Retirer de ma bibliothèque Imprimer
Export

    Export citations

  • Fichier

  • Contenu

Vol 44 - N° 4

P. 660-664 - avril 2001 Retour au numéro
Article précédent Article précédent
  • Mohs micrographic surgery for the treatment of spindle cell tumors of the skin
  • Michael J. Huether, John A. Zitelli, David G. Brodland
| Article suivant Article suivant
  • Conscious sedation in dermatologic surgery
  • Mary Christian, Lucy Yeung, Ronda Williams, Ronald Moy

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 ?

;

Mon compte


Plateformes Elsevier Masson

Déclaration CNIL

EM-CONSULTE.COM est déclaré à la CNIL, déclaration n° 1286925.

En application de la loi nº78-17 du 6 janvier 1978 relative à l'informatique, aux fichiers et aux libertés, vous disposez des droits d'opposition (art.26 de la loi), d'accès (art.34 à 38 de la loi), et de rectification (art.36 de la loi) des données vous concernant. Ainsi, vous pouvez exiger que soient rectifiées, complétées, clarifiées, mises à jour ou effacées les informations vous concernant qui sont inexactes, incomplètes, équivoques, périmées ou dont la collecte ou l'utilisation ou la conservation est interdite.
Les informations personnelles concernant les visiteurs de notre site, y compris leur identité, sont confidentielles.
Le responsable du site s'engage sur l'honneur à respecter les conditions légales de confidentialité applicables en France et à ne pas divulguer ces informations à des tiers.