Melanoma biopsy: Difference between revisions
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==Biopsy== | ==Biopsy== | ||
*Patients who have lesions suspected to be melanoma should always be biopsied. | *Patients who have lesions suspected to be melanoma should always be biopsied. | ||
*An excisional biopsy (either elliptical, punch, or | *An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended. | ||
*Shave biopsy is acceptable only when the index of suspicion for melanoma is low. | *Shave biopsy is acceptable only when the index of suspicion for melanoma is low. | ||
*The following should be reported when a biopsy is being reported: | *The following should be reported when a biopsy is being reported: | ||
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{{familytree/start |summary=Approach to melanoma}} | {{familytree/start |summary=Approach to melanoma}} | ||
{{familytree | | | | | | | | | A01 | | | | | | | | | | | | | A01=Suspicious pigmented lesion}} | {{familytree | | | | | | | | | A01 | | | | | | | | | | | | | A01=Suspicious pigmented lesion}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | B01 | | | | | | | | | | | | | B01=Biopsy}} | {{familytree | | | | | | | | | B01 | | | | | | | | | | | | | B01=Biopsy}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | |,|-|^|-|.| | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | | | C01 | | | | | | | | | | | C01=Inadequate}} | {{familytree | | | | | | | |!| | | C01 | | | | | | | | | | | C01=Inadequate}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | |!| | | |!| | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | | | D01 | | | | | | | | | | | D01=Rebiopsy}} | {{familytree | | | | | | | |!| | | D01 | | | | | | | | | | | D01=Rebiopsy}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | |`|-|v|-|'| | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | E01 | | | | | | | | | | | | | E01=Melanoma confirmed}} | {{familytree | | | | | | | | | E01 | | | | | | | | | | | | | E01=Melanoma confirmed}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | |,|-|-|-|v|-|-|-|+|-|-|-|v|-|-|-|v|-|-|-|.| | }} | ||
{{familytree | F01 | | F02 | | F03 | | F04 | | F05 | | F06 | F01=Breslow thickness|E02=Ulceration status|E03=Mitotic rate|E04=Depth and peripheral margin status|E05=Presence of satellitosis|E06=Clark level for lesions ≤ 1 mm | {{familytree | F01 | | F02 | | F03 | | F04 | | F05 | | F06 | F01=Breslow thickness|E02=Ulceration status|E03=Mitotic rate|E04=Depth and peripheral margin status|E05=Presence of satellitosis|E06=Clark level for lesions ≤ 1 mm}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | G01 | | | | | | | | | | | | | G01=Reassessment with complete physical examination, including neurological exam and lymph node assessment}} | {{familytree | | | | | | | | | G01 | | | | | | | | | | | | | G01=Reassessment with complete physical examination, including neurological exam and lymph node assessment}} | ||
{{familytree | | | | | | | | | | | | | | | | | | | | | | | | }} | {{familytree | | | | | | | | | |!| | | | | | | | | | | | | | }} | ||
{{familytree | | | | | | | | | H01 | | | | | | | | | | | | | H01=Staging}} | {{familytree | | | | | | | | | H01 | | | | | | | | | | | | | H01=Staging}} | ||
{{familytree/end}} | {{familytree/end}} | ||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 00:37, 22 August 2015
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Melanoma Microchapters |
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Diagnosis |
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Treatment |
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Case Studies |
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Melanoma biopsy On the Web |
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American Roentgen Ray Society Images of Melanoma biopsy |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.
Overview
Biopsy
- Patients who have lesions suspected to be melanoma should always be biopsied.
- An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended.
- Shave biopsy is acceptable only when the index of suspicion for melanoma is low.
- The following should be reported when a biopsy is being reported:
- Location
- Regression
- Tumor infiltrating lymphocytes
- Breslow thickness and vertical growth phase
- Histologic ulceration
- Clark level
- Angiolymphatic invasion
- Neurotropism
- Histologic subtype
| Suspicious pigmented lesion | |||||||||||||||||||||||||||||||||||||||||||||||
| Biopsy | |||||||||||||||||||||||||||||||||||||||||||||||
| Inadequate | |||||||||||||||||||||||||||||||||||||||||||||||
| Rebiopsy | |||||||||||||||||||||||||||||||||||||||||||||||
| Melanoma confirmed | |||||||||||||||||||||||||||||||||||||||||||||||
| Breslow thickness | {{{ F02 }}} | {{{ F03 }}} | {{{ F04 }}} | {{{ F05 }}} | {{{ F06 }}} | ||||||||||||||||||||||||||||||||||||||||||
| Reassessment with complete physical examination, including neurological exam and lymph node assessment | |||||||||||||||||||||||||||||||||||||||||||||||
| Staging | |||||||||||||||||||||||||||||||||||||||||||||||