Pigmented lesion pathology: what you should expect from your pathologist, and what your pathologist should expect from you.
The first part of this review examines the reliability of histologic diagnosis in pigmented lesions, as measured by concordance studies and medicolegal analysis. It emphasizes the role of clinicians in maximizing that reliability, by providing adequate clinical descriptions, using appropriate biopsy technique, and critically interpreting pathology reports. It identifies those entities that are especially problematic, either because they cannot be reliably recognized by the histopathologist or because their histology is a poor guide to their biologic behavior. The second part of the review is a guide to some of the more difficult and controversial pigmented lesions, including dysplastic nevus, spitzoid nevi and melanomas, cellular blue nevus, animal-type melanoma, and deep penetrating nevus.
Fleming
Matthew G
MG
Department of Dermatology, Medical College of Wisconsin, 8701 Watertown Plank Road, Milwaukee, WI 53226, USA. mfleming@mcw.edu
D001706:Biopsy / Q000592:standards; D003142:Communication; D046169:Dermoscopy; D003951:Diagnostic Errors; D006801:Humans; D007400:Interprofessional Relations; D008545:Melanoma / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000473:pathology; D010338:Pathology, Clinical; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology / Q000601:surgery; D013048:Specimen Handling