Immunohistochemical staining of lentigo maligna during Mohs micrographic surgery using MART-1.
BACKGROUND
Lentigo maligna (LM) often displays extensive subclinical spread. Mohs micrographic surgery (MMS) has been proposed to help delineate the true histologic margin; however, visualizing atypical melanocytes on frozen section is challenging and often requires confirmatory permanent paraffin sections.


OBJECTIVE
Our aim was to use a monoclonal antibody to rapidly stain frozen sections during MMS to facilitate better visualization of atypical melanocytes.


METHODS
Frozen sections of LM during MMS were stained with MART-1 (melanoma antigen recognized by T cells) and compared with paraffin-embedded sections.


RESULTS
We found 100% correlation between frozen sections stained with MART-1 and paraffin-embedded sections.


CONCLUSIONS
Atypical melanocytes can be better visualized on frozen sections of LM by using MART-1 rather than hematoxylin and eosin. This allows for easier identification during MMS and better chance of complete removal of LM lesions.
Kelley
Larisa C
LC
Department of Dermatologic Surgery, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, Massachusetts, USA.
Starkus
Laurie
L
D000951:Antigens, Neoplasm; D016022:Case-Control Studies; D006801:Humans; D018327:Hutchinson's Melanotic Freckle / Q000473:pathology* / Q000601:surgery*; D007150:Immunohistochemistry; D058965:MART-1 Antigen; D015580:Mohs Surgery / Q000379:methods*; D009363:Neoplasm Proteins; D016612:Paraffin Embedding; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000473:pathology* / Q000601:surgery*; D013048:Specimen Handling
D000951:Antigens, Neoplasm; D058965:MART-1 Antigen; C548667:MLANA protein, human; D009363:Neoplasm Proteins