Sampling of melanocytic nevi for research purposes: A prospective, pilot study to determine effect on diagnosis

Scott R. Florell, Bruce R. Smoller, Kenneth M. Boucher, Douglas Grossman, Ronald M. Harris, Glen M. Bowen, Sancy Leachman

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Background: Research on melanocytic nevi predominantly utilizes formalin-fixed, paraffin-embedded tissue, largely limiting research to morphologic and immunohistochemical observations. Withholding portions of fresh nevus tissue for molecular studies could result in the loss of important diagnostic material. Objective: This study prospectively evaluated melanocytic nevi for histologic homogeneity to determine if using a portion for research would have affected diagnosis. Methods: Thirty-three subjects were enrolled in a prospective study in which pigmented lesions were chosen for biopsy on a clinical basis. Lesions were sectioned and each piece submitted in a separate block (mean, 2.7; range 2-5 blocks per lesion). Slides from nevi were examined in two phases. In phase I, sections of nevi were randomized and a diagnosis was rendered for each section of nevus. In phase II, the dermatopathologist reviewed all slides for each nevus as a case, similar to the original interpretation of the lesion provided to the clinician. Diagnoses from phases I and II were compared with the original diagnosis. Results: Case material included 51 melanocytic lesions from 31 subjects. The phase I diagnosis matched the original diagnosis for 99 of 121 slides that showed a melanocytic lesion (82%). The phase II diagnosis matched the original diagnosis for 45 of 51 specimens (88%). Limitations: The study was limited by: a small number of specimens; the clinician could have chosen clinically homogeneous nevi for biopsy; effect of interobserver and intraobserver variability on diagnosis. Conclusions: For the majority of melanocytic nevi in this study, the diagnostic information present in one section of a melanocytic nevus could be extrapolated to the remainder of the specimen without adverse consequences from a diagnostic or therapeutic perspective.

Original languageEnglish (US)
Pages (from-to)814-821
Number of pages8
JournalJournal of the American Academy of Dermatology
Volume59
Issue number5
DOIs
StatePublished - Nov 2008
Externally publishedYes

Fingerprint

Pigmented Nevus
Nevus
Prospective Studies
Research
Biopsy
Observer Variation
Paraffin
Formaldehyde

ASJC Scopus subject areas

  • Dermatology

Cite this

Sampling of melanocytic nevi for research purposes : A prospective, pilot study to determine effect on diagnosis. / Florell, Scott R.; Smoller, Bruce R.; Boucher, Kenneth M.; Grossman, Douglas; Harris, Ronald M.; Bowen, Glen M.; Leachman, Sancy.

In: Journal of the American Academy of Dermatology, Vol. 59, No. 5, 11.2008, p. 814-821.

Research output: Contribution to journalArticle

Florell, Scott R. ; Smoller, Bruce R. ; Boucher, Kenneth M. ; Grossman, Douglas ; Harris, Ronald M. ; Bowen, Glen M. ; Leachman, Sancy. / Sampling of melanocytic nevi for research purposes : A prospective, pilot study to determine effect on diagnosis. In: Journal of the American Academy of Dermatology. 2008 ; Vol. 59, No. 5. pp. 814-821.
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abstract = "Background: Research on melanocytic nevi predominantly utilizes formalin-fixed, paraffin-embedded tissue, largely limiting research to morphologic and immunohistochemical observations. Withholding portions of fresh nevus tissue for molecular studies could result in the loss of important diagnostic material. Objective: This study prospectively evaluated melanocytic nevi for histologic homogeneity to determine if using a portion for research would have affected diagnosis. Methods: Thirty-three subjects were enrolled in a prospective study in which pigmented lesions were chosen for biopsy on a clinical basis. Lesions were sectioned and each piece submitted in a separate block (mean, 2.7; range 2-5 blocks per lesion). Slides from nevi were examined in two phases. In phase I, sections of nevi were randomized and a diagnosis was rendered for each section of nevus. In phase II, the dermatopathologist reviewed all slides for each nevus as a case, similar to the original interpretation of the lesion provided to the clinician. Diagnoses from phases I and II were compared with the original diagnosis. Results: Case material included 51 melanocytic lesions from 31 subjects. The phase I diagnosis matched the original diagnosis for 99 of 121 slides that showed a melanocytic lesion (82{\%}). The phase II diagnosis matched the original diagnosis for 45 of 51 specimens (88{\%}). Limitations: The study was limited by: a small number of specimens; the clinician could have chosen clinically homogeneous nevi for biopsy; effect of interobserver and intraobserver variability on diagnosis. Conclusions: For the majority of melanocytic nevi in this study, the diagnostic information present in one section of a melanocytic nevus could be extrapolated to the remainder of the specimen without adverse consequences from a diagnostic or therapeutic perspective.",
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