title: Nuclear and cytoplasmic features in the diagnosis of banal nevi, Spitz nevi, and melanoma.
abstract: BACKGROUND
  Many authors have described cytologic features in a variety of melanocytic lesions but, to our knowledge, a statistical analysis of sensitivity, specificity, and overall accuracy of these features alone or in combination has not been performed.
  
  
  OBJECTIVE
  We sought to determine the diagnostic value of nuclear and cytoplasmic characteristics in the diagnosis of melanocytic lesions via multivariate statistical analysis.
  
  
  METHODS
  This is a retrospective observational study conducted on 300 melanocytic lesions. We evaluated a series of distinctive features; subsequently a multivariate model was used to determine sensitivity and specificity.
  
  
  RESULTS
  Major features that favor a diagnosis of melanoma include: pleomorphism with enlarged nuclei, mitotic figures, notching/corrugation of the nuclear envelope, and peppered moth nucleus. Features with intermediate value include: solid hyperchromasia, vesicular nucleus with single round nucleolus, and nuclear/cytoplasmic ratio greater than 4:1.
  
  
  CONCLUSIONS
  Limitations of this study include its retrospective nature, and the reliance on the original diagnostic classification of each neoplasm.
  
  
  CONCLUSIONS
  Our data suggest that some nuclear alterations have greater value in the diagnosis of benign and malignant melanocytic lesions.
authors.affiliation: Ackerman Academy of Dermatopathology, New York, New York.
authors.forename: Manuel
authors.initials: M
authors.lastname: Valdebran
authors.affiliation: Ackerman Academy of Dermatopathology, New York, New York; Department of Dermatology, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Amira
authors.initials: A
authors.lastname: Elbendary
authors.affiliation: Department of Pathology, University of Toledo Medical Center, Toledo, Ohio.
authors.forename: Sri Krishna
authors.initials: SK
authors.lastname: Chaitanya Arudra
authors.affiliation: Ackerman Academy of Dermatopathology, New York, New York.
authors.forename: Kara Melissa
authors.initials: KM
authors.lastname: Torres
authors.affiliation: Department of Biostatistics and Cancer Epidemiology, National Cancer Institute, Kasr Al Ainy Faculty of Medicine, Cairo University, Cairo, Egypt.
authors.forename: Inas
authors.initials: I
authors.lastname: Elattar
authors.affiliation: Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, Charleston, South Carolina. Electronic address: elstond@musc.edu.
authors.forename: Dirk M
authors.initials: DM
authors.lastname: Elston
mesh_terms: D002466:Cell Nucleolus / Q000648:ultrastructure; D002467:Cell Nucleus / Q000648:ultrastructure*; D002843:Chromatin / Q000648:ultrastructure; D003593:Cytoplasm / Q000648:ultrastructure*; D006801:Humans; D008545:Melanoma / Q000175:diagnosis / Q000648:ultrastructure*; D008938:Mitosis; D008962:Models, Theoretical; D015999:Multivariate Analysis; D018332:Nevus, Epithelioid and Spindle Cell / Q000175:diagnosis / Q000648:ultrastructure*; D009508:Nevus, Pigmented / Q000175:diagnosis / Q000648:ultrastructure*; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D012878:Skin Neoplasms / Q000175:diagnosis / Q000648:ultrastructure*; D013194:Staining and Labeling; D000096142:Cutaneous Malignant Melanoma
chemical_list: D002843:Chromatin
keywords: Spitz nevus; banal nevi; chromatin; cytology; cytoplasm; melanoma; nucleus