Melanoma biopsy: Difference between revisions
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==Biopsy== | |||
*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.<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.<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:<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 | |||
:*Regression | |||
:*Tumor infiltrating lymphocytes | |||
:*Breslow thickness and vertical growth phase | |||
:*Histologic ulceration | |||
:*Clark level | |||
:*Angiolymphatic invasion | |||
:*Neurotropism | |||
:*Histologic subtype | |||
<br> | |||
To view characteristic features of all subtypes of melanoma, click [[Melanoma pathophysiology#Pathology|'''here''']] | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Revision as of 02:48, 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
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 | |||||||||||||||||||||||||||||||||||||||||||||||
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
To view characteristic features of all subtypes of melanoma, click here