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Yu N, Wu L, Su J, Huang K, Liu S, Lu L, Li Y, Jiang Z, Zheng A, Zhu Z, Liao M, Zhao S, Wei T. Preoperative Ultrasound-Guided Incisional Biopsy Enhances the Pathological Accuracy of Incisional Biopsy of Cutaneous Melanoma: A Prospective Clinical Trial in Chinese Patients. JOURNAL OF ULTRASOUND IN MEDICINE : OFFICIAL JOURNAL OF THE AMERICAN INSTITUTE OF ULTRASOUND IN MEDICINE 2022; 41:2841-2848. [PMID: 35233820 DOI: 10.1002/jum.15972] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Revised: 02/07/2022] [Accepted: 02/12/2022] [Indexed: 06/14/2023]
Abstract
OBJECTIVES To assess the feasibility of preoperative ultrasound (US)-guided incisional biopsy through a prospective controlled clinical trial. METHODS This was a prospective, double-arm, single-center study of Chinese patients. Thirty patients were enrolled in the study. Fourteen patients received incisional biopsies for which the choice of biopsy area relied on a clinical evaluation, and 16 patients received incisional biopsies for which the choice of biopsy area relied on a US-guided evaluation. The following procedure was used in the US-guided incisional biopsy group: 1) clinical and dermoscopic evaluation of skin lesions; 2) US examination; 3) incisional biopsy; 4) surgical excision; and 5) histopathological examination. The same procedure was used in the non-US-guided group except without US examination. RESULTS In the non-US-guided group, the mean tumor thicknesses obtained from incisional biopsy and postoperative histopathological examination were 2.1 and 4.1 mm, respectively. Seven melanomas were underestimated by incisional biopsy, resulting in margins narrower than currently recommended. In the US-guided group, the mean tumor thicknesses obtained from US, incisional biopsy, and postoperative histopathological examination were 3.4, 2.9, and 2.7 mm, respectively. In only 3 melanomas was the tumor thickness of the incisional biopsy less than that of the postoperative histopathological examination, demonstrating that US-guided biopsy obtains the maximum thickness area. CONCLUSIONS Preoperative US-guided incisional biopsy can enhance the pathological accuracy of incisional biopsy, which may allow us to better perform surgical excision with safe peripheral surgical margins.
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Affiliation(s)
- Nianzhou Yu
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Dermatology Department of Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Lisha Wu
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Juan Su
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Dermatology Department of Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Kai Huang
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Dermatology Department of Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Siliang Liu
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Dermatology Department of Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Lixia Lu
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Dermatology Department of Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Yixin Li
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Zixi Jiang
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Aojie Zheng
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Zirui Zhu
- Xiangya School of Medicine, Central South University, Changsha, China
| | - Mengting Liao
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Shuang Zhao
- Hunan Engineering Research Center of Skin Health and Disease, Changsha, China
- Hunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, China
- Dermatology Department of Xiangya Hospital of Central South University, Changsha, China
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
| | - Tianhong Wei
- National Clinical Research Center for Geriatric Disorders, Xiangya Hospital, Changsha, Hunan, China
- Department of Ultrasound, Xiangya Hospital, Central South University, Changsha, China
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Schukow CP, Schaeffer M, Boss K, Fivenson D. Management of a Unique Presentation of a Common Dermatologic Condition. Spartan Med Res J 2021; 6:24501. [PMID: 34589664 PMCID: PMC8405279 DOI: 10.51894/001c.24501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2021] [Accepted: 06/01/2021] [Indexed: 11/24/2022] Open
Abstract
CONTEXT Skin rashes are a common complaint seen in the primary care setting. There are many dermatologic conditions which a primary care provider (PCP) should be able to recognize and manage. One such condition is granuloma annulare (GA), which commonly presents as smooth, annular plaques on the trunk and/or extremities. Rashes like GA rarely present as unique variants and may be difficult for PCPs to determine from patient history and physical exam alone. Patch granuloma annulare (patch GA) is an example that may clinically mimic a cutaneous lymphoma known as mycosis fungoides (MF). PCPs should ideally be able to recognize the utility of performing a skin biopsy and/or referring the patient to a dermatologist when history and physical exam alone are insufficient. The histologic findings of skin biopsies often become essential in establishing a proper diagnosis and guiding patient management in unique dermatologic variants. EXAMPLE CASE The patient in this clinical practice report is a Caucasian female in her late 60s who presented to a dermatology clinic with a two-year history of a worsening widespread eruption on her trunk and extremities. She had been evaluated previously by her PCP about 4 months prior and, without obtaining skin biopsies, treated her with a medium potency topical corticosteroid cream. The eruption had spread over her hips, buttocks, back, thighs, wrists, and elbows. Multiple skin biopsies of affected sites were taken by the second author and revealed findings consistent with patch GA. The patient was started on topical betamethasone dipropionate 0.05% ointment twice daily and noted marked improvement of her symptoms. CONCLUSIONS Although GA is a benign condition of the skin that may be readily detected by PCPs, skin biopsies may be necessary to establish a proper diagnosis when this condition presents as a unique variant (e.g., patch GA). Therapy for patch GA often begins with a trial of high-potency topical steroid therapy in combination with ultraviolet light exposure, depending on disease severity and patient preference. Early evaluation with a skin biopsy by her PCP or an earlier referral to a dermatologist to have skin biopsies performed likely would have helped establish a prompter diagnosis and treatment plan for this patient.
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Affiliation(s)
| | | | - Katherine Boss
- Michigan State University College of Osteopathic Medicine
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Kok Y, Scott K, Pham A, Liu W, Roberts H, Pan Y, McLean C, Chamberlain A, Kelly JW, Mar VJ. The impact of incomplete clinical information and initial biopsy technique on the histopathological diagnosis of cutaneous melanoma. Australas J Dermatol 2021; 62:e524-e531. [PMID: 34426977 DOI: 10.1111/ajd.13697] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Revised: 07/11/2021] [Accepted: 07/27/2021] [Indexed: 12/18/2022]
Abstract
BACKGROUND/OBJECTIVES Increased rates of histopathological misdiagnosis of melanoma have been associated with incisional punch more so than shave biopsy when compared with complete excisional biopsy. It is unknown how the increasing utilisation of shave biopsy may impact melanoma diagnosis. The extent to which the provision of clinical information to the pathologist may improve diagnostic accuracy remains unclear. This study assessed the impact of both initial biopsy technique and provision of adequate clinical information to pathologists on the accuracy of histopathological diagnosis of melanoma and disease progression. METHODS We conducted a retrospective cohort with nested case-control study of all histopathological false-negative and false-positive melanoma diagnoses from January 2014 to May 2019 from the Victorian Melanoma Service electronic database. Cases were assessed for the initial biopsy type, provision of clinical information on pathology request forms and disease progression associated with false-negative diagnosis. RESULTS Partial shave biopsy had higher odds of false-negative (OR 5.19, 95% CI 2.89-9.32; P < 0.001) and false-positive diagnoses (OR 1.95, 95% CI 1.45-2.63; P < 0.001) of melanoma when compared with elliptical excisional biopsy. These odds ratios were comparable with those found with incisional punch biopsy. Providing the suspected clinical diagnosis to pathologists also reduced the odds of false-negative diagnosis with melanoma progression by 3.8-fold (P = 0.02). CONCLUSION The choice of initial biopsy technique and providing the suspected clinical diagnosis to pathologists are important for correct histopathological diagnosis of cutaneous melanoma and prevention of further disease progression.
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Affiliation(s)
- Yonatan Kok
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia
| | - Karen Scott
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia
| | - Alan Pham
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Anatomical Pathology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Wenyuan Liu
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia
| | - Hugh Roberts
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Skin Health Institute, Melbourne, VIC, Australia
| | - Yan Pan
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Catriona McLean
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Department of Anatomical Pathology, The Alfred Hospital, Melbourne, VIC, Australia
| | - Alex Chamberlain
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - John W Kelly
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,Central Clinical School, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, VIC, Australia
| | - Victoria J Mar
- Victorian Melanoma Service, The Alfred Hospital, Melbourne, VIC, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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4
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Menezes SL, Kelly JW, Wolfe R, Farrugia H, Mar VJ. The increasing use of shave biopsy for diagnosing invasive melanoma in Australia. Med J Aust 2019; 211:213-218. [DOI: 10.5694/mja2.50289] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Accepted: 03/22/2019] [Indexed: 12/30/2022]
Affiliation(s)
- Sara L Menezes
- Victorian Melanoma ServiceAlfred Hospital Melbourne VIC
- Monash University Central Clinical School Melbourne VIC
| | - John W Kelly
- Victorian Melanoma ServiceAlfred Hospital Melbourne VIC
- Monash University Central Clinical School Melbourne VIC
| | - Rory Wolfe
- Monash University Central Clinical School Melbourne VIC
| | - Helen Farrugia
- Victorian Cancer RegistryCancer Council Victoria Melbourne VIC
| | - Victoria J Mar
- Victorian Melanoma ServiceAlfred Hospital Melbourne VIC
- Skin and Cancer Foundation Melbourne VIC
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Weitman ES, Perez MC, Lee D, Kim Y, Fulp W, Sondak VK, Sarnaik AA, Gonzalez RJ, Cruse CW, Messina JL, Zager JS. Re-biopsy of partially sampled thin melanoma impacts sentinel lymph node sampling as well as surgical margins. Melanoma Manag 2019; 6:MMT17. [PMID: 31406562 PMCID: PMC6688556 DOI: 10.2217/mmt-2018-0011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2018] [Accepted: 02/28/2019] [Indexed: 11/26/2022] Open
Abstract
AIM To assess the impact of re-biopsy on partially sampled melanoma in situ (MIS), atypical melanocytic proliferation (AMP) and thin invasive melanoma. MATERIALS & METHODS We retrospectively identified cases of re-biopsied partially sampled neoplasms initially diagnosed as melanoma in situ, AMP or thin melanoma (Breslow depth ≤0.75 mm). RESULTS & CONCLUSION Re-biopsy led to sentinel lymph node biopsy (SLNB) in 18.3% of cases. No patients upstaged from AMP or MIS had a positive SLNB. One out of nine (11.1%) initially diagnosed as a thin melanoma ≤0.75 mm, upstaged with a re-biopsy, had a positive SLNB. After re-biopsy 8.5% underwent an increased surgical margin. Selective re-biopsy of partially sampled melanoma with gross residual disease can increase the accuracy of microstaging and optimize treatment regarding surgical margins and SLNB.
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Affiliation(s)
- Evan S Weitman
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Matthew C Perez
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Daniel Lee
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Youngchul Kim
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - William Fulp
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Vernon K Sondak
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Amod A Sarnaik
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Ricardo J Gonzalez
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Carl W Cruse
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Jane L Messina
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
| | - Jonathan S Zager
- Moffitt Cancer Center, Department of Cutaneous Oncology, 12902 Magnolia Drive, Tampa, FL 33602, USA
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Dong S, Zhao N, Deng W, Sun HW, Niu FY, Yang JJ, Zhong WZ, Li F, Yan HH, Xu CR, Zhang QY, Yang XN, Liao RQ, Nie Q, Wu YL. Supraclavicular lymph node incisional biopsies have no influence on the prognosis of advanced non-small cell lung cancer patients: a retrospective study. World J Surg Oncol 2017; 15:12. [PMID: 28069039 PMCID: PMC5223594 DOI: 10.1186/s12957-016-1064-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2016] [Accepted: 12/14/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Supraclavicular lymph node (SCLN) biopsies play an important role in diagnosing and staging lung cancer. However, not all patients with SCLN metastasis can have a complete resection. It is still unknown whether SCLN incisional biopsies affect the prognosis of non-small cell lung cancer (NSCLC) patients. METHODS Patients who were histologically confirmed to have NSCLC with SCLN metastasis were enrolled in the study from January 2007 to December 2012 at Guangdong Lung Cancer Institute. The primary endpoint was OS, and the secondary endpoints were complications and local recurrence/progression. RESULTS Two hundred two consecutive patients who had histologically confirmed NSCLC with SCLN metastasis were identified, 163 with excisional and 39 with incisional biopsies. The median OS was not significantly different between the excisional (10.9 months, 95% CI 8.7-13.2) and incisional biopsy groups (10.1 months, 95% CI 6.3-13.9), P = 0.569. Multivariable analysis showed that an Eastern Cooperative Oncology Group (ECOG) performance status (PS) ≥2 (HR = 2.75, 95% CI 1.71-4.38, P < 0.001) indicated a worse prognosis. Having an epidermal growth factor receptor (EGFR) mutation (HR = 0.58, 95% CI 0.40-0.84, P = 0.004) and receiving systemic treatment (HR = 0.36, 95% CI 0.25-0.53, P < 0.001) were associated with a favorable OS. Neither the number (multiple vs. single) nor site (bilateral vs. unilateral) of SCLNs was associated with an unfavorable OS, and SCLN size or fixed SCLNs did not affect OS. CONCLUSIONS SCLN incisional biopsies did not negatively influence the prognosis of NSCLC patients. It was safe and feasible to partly remove a metastatic SCLN as a last resort in advanced NSCLC.
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Affiliation(s)
- Song Dong
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Ning Zhao
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.,Department of Thoracic Surgery, The First People's Hospital of Foshan, Foshan, People's Republic of China
| | - Wei Deng
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.,Southern Medical University, Guangzhou, People's Republic of China
| | - Hui-Wen Sun
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.,Southern Medical University, Guangzhou, People's Republic of China
| | - Fei-Yu Niu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.,Southern Medical University, Guangzhou, People's Republic of China
| | - Jin-Ji Yang
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Wen-Zhao Zhong
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Feng Li
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.,Southern Medical University, Guangzhou, People's Republic of China
| | - Hong-Hong Yan
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Chong-Rui Xu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Qiu-Yi Zhang
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.,Southern Medical University, Guangzhou, People's Republic of China
| | - Xue-Ning Yang
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Ri-Qiang Liao
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Qiang Nie
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China
| | - Yi-Long Wu
- Guangdong Lung Cancer Institute, Guangdong General Hospital & Guangdong Academy of Medical Science, 106 Zhongshan 2nd Road, Guangzhou, 510080, People's Republic of China.
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Abstract
As cutaneous melanomas manifest a wide spectrum of clinical and pathologic presentations, several other lesions enter into their differential diagnosis. This article considers those entities, including melanocytic hyperplasia, cellular nodules in congenital nevi, atypical lentiginous melanocytic proliferations, "special site" nevi, epithelioid histiocytoma, neurothekeoma, cellular schwannoma, and proliferating scars.
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Affiliation(s)
- Mark R Wick
- Division of Surgical Pathology and Cytopathology, University of Virginia Medical Center, Room 3020, 1215 Lee St, Charlottesville, Virginia 22908-0214.
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Cheng R, Bialas RW, Chiu ST, Lawrence TJ, Lesesky EB. Punch biopsy vs. shave biopsy: a comparison of margin status of clinically atypical pigmented lesions. Br J Dermatol 2015; 173:849-51. [PMID: 25864555 DOI: 10.1111/bjd.13830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R Cheng
- Duke University School of Medicine, Durham, NC, U.S.A
| | - R W Bialas
- Department of Dermatology, Duke University Medical Center, Durham, NC, U.S.A
| | - S T Chiu
- Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, U.S.A
| | - T J Lawrence
- Department of Pathology, Duke University Medical Center, Durham, NC, U.S.A
| | - E B Lesesky
- Department of Dermatology, Duke University Medical Center, Durham, NC, U.S.A
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Selected Benign Lesions That May Be Confused Pathologically With Cutaneous Melanoma. AJSP-REVIEWS AND REPORTS 2015. [DOI: 10.1097/pcr.0000000000000080] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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10
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Current biopsy practices for suspected melanoma: A survey of family physicians in Southwestern Ontario. Plast Surg (Oakv) 2014. [DOI: 10.1177/229255031402200306] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
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