Melanoma biopsy: Difference between revisions
Jump to navigation
Jump to search
YazanDaaboul (talk | contribs) |
YazanDaaboul (talk | contribs) No edit summary |
||
| Line 4: | Line 4: | ||
==Overview== | ==Overview== | ||
==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.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343 }} </ref> | ||
*An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended. | *An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343 }} </ref> | ||
*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.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343 }} </ref> | ||
*The following should be reported when a biopsy is being reported: | *The following should be reported when a biopsy is being reported:<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343 }} </ref> | ||
:*Location | :*Location | ||
:*Regression | :*Regression | ||
| Line 18: | Line 18: | ||
:*Histologic subtype | :*Histologic subtype | ||
==Approach to Patients with Suspected Melanoma== | ==Approach to Patients with Suspected Melanoma== | ||
The following algorithm illustrates the approach to patients with suspected melanoma. | The following algorithm illustrates the approach to patients with suspected melanoma.<ref name="pmid23584343">{{cite journal| author=Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A et al.| title=Melanoma, version 2.2013: featured updates to the NCCN guidelines. | journal=J Natl Compr Canc Netw | year= 2013 | volume= 11 | issue= 4 | pages= 395-407 | pmid=23584343 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23584343 }} </ref> | ||
{{familytree/start |summary=Approach to melanoma}} | {{familytree/start |summary=Approach to melanoma}} | ||
{{familytree | | | | | | | | | A01 | | | | | | | | | | | | | A01=<div style="width: 7em; padding:1em;">Suspicious pigmented lesion</div>}} | {{familytree | | | | | | | | | A01 | | | | | | | | | | | | | A01=<div style="width: 7em; padding:1em;">Suspicious pigmented lesion</div>}} | ||
Revision as of 00:50, 22 August 2015
|
Melanoma Microchapters |
|
Diagnosis |
|---|
|
Treatment |
|
Case Studies |
|
Melanoma biopsy On the Web |
|
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.[1]
- An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended.[1]
- Shave biopsy is acceptable only when the index of suspicion for melanoma is low.[1]
- The following should be reported when a biopsy is being reported:[1]
- Location
- Regression
- Tumor infiltrating lymphocytes
- Breslow thickness and vertical growth phase
- Histologic ulceration
- Clark level
- Angiolymphatic invasion
- Neurotropism
- Histologic subtype
Approach to Patients with Suspected Melanoma
The following algorithm illustrates the approach to patients with suspected melanoma.[1]
Suspicious pigmented lesion | |||||||||||||||||||||||||||||||||||||||||||||||
Biopsy | |||||||||||||||||||||||||||||||||||||||||||||||
Inadequate | |||||||||||||||||||||||||||||||||||||||||||||||
Rebiopsy | |||||||||||||||||||||||||||||||||||||||||||||||
Melanoma confirmed | |||||||||||||||||||||||||||||||||||||||||||||||
Breslow thickness | Ulceration status | Mitotic rate | Depth and peripheral margin status | Presence of satellitosis | Clark level for lesions ≤ 1 mm | ||||||||||||||||||||||||||||||||||||||||||
Reassessment with complete physical examination, including neurological exam and lymph node assessment | |||||||||||||||||||||||||||||||||||||||||||||||