Diagnosis of metastatic melanoma by fine-needle biopsy: analysis of 2,204 cases.
Fine-needle biopsy (FNB) has been reported as a rapid, minimally invasive technique for the diagnosis of metastatic melanoma. The diagnostic accuracy of FNB was assessed in a consecutive series of 2,204 FNBs of clinically suspicious lesions from patients with previous primary melanomas treated at the Sydney Melanoma Unit, Sydney, Australia, between January 1992 and December 2002. The sensitivity and specificity of FNB were 96.3% and 98.9%, respectively. There were 5 false-positive cases (0.6%), which were verified as metastatic adenocarcinoma (3 cases) or reactive processes (organizing hematoma and chronic osteomyelitis, 1 each). False-negative diagnoses (6.7% of cases) were associated with a variety of clinicopathologic factors, including difficult-to-access anatomic sites (eg, high axilla or deep inguinal), small lesions, and lesional characteristics such asfibrosis, necrosis, or cystic change. FNB is a highly accurate, rapid, and cost-effective procedure for the diagnosis of metastatic melanoma and should be considered as the initial diagnostic procedure of choice in patients with melanoma with clinically suspected metastases.
Murali
Rajmohan
R
Department of Anatomical Pathology, Sydney Cancer Centre, Australia.
Doubrovsky
Anna
A
Watson
Geoffrey F
GF
McKenzie
Paul R
PR
Lee
C Soon
CS
McLeod
Duncan J
DJ
Uren
Roger F
RF
Stretch
Jonathan R
JR
Saw
Robyn P M
RP
Thompson
John F
JF
Scolyer
Richard A
RA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D044963:Biopsy, Fine-Needle / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data; D003937:Diagnosis, Differential; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008545:Melanoma / Q000175:diagnosis* / Q000378:metabolism / Q000556:secondary*; D008875:Middle Aged; D015203:Reproducibility of Results; D009418:S100 Proteins / Q000032:analysis; D012680:Sensitivity and Specificity
D009418:S100 Proteins