• Complain

Christopher R. Shea - Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management

Here you can read online Christopher R. Shea - Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management full text of the book (entire story) in english for free. Download pdf and epub, get meaning, cover and reviews about this ebook. year: 2014, publisher: Springer, genre: Romance novel. Description of the work, (preface) as well as reviews are available. Best literature library LitArk.com created for fans of good reading and offers a wide selection of genres:

Romance novel Science fiction Adventure Detective Science History Home and family Prose Art Politics Computer Non-fiction Religion Business Children Humor

Choose a favorite category and find really read worthwhile books. Enjoy immersion in the world of imagination, feel the emotions of the characters or learn something new for yourself, make an fascinating discovery.

Christopher R. Shea Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management

Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management: summary, description and annotation

We offer to read an annotation, description, summary or preface (depends on what the author of the book "Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management" wrote himself). If you haven't found the necessary information about the book — write in the comments, we will try to find it.

Melanocytic neoplasms are of capital importance for all surgical pathologists and dermatopathologists. These tumors span a huge range of morphologic expression and biologic behavior, are potentially of the highest medical significance and are often fraught with diagnostic pitfalls and high litigation risk. Pathology of Challenging Melanocytic Neoplasms offers a dynamic text where readers will encounter a broad spectrum of challenging melanocytic lesions, both benign and malignant and will thereby acquire a solid, working knowledge that they can immediately apply to daily diagnosis. The authors aim to clarify this often thorny field, keeping a steady focus on patient-related issues. The volume emphasizes the practical application of basic morphologic principles, immunohistochemistry and molecular methods in order to secure a confident diagnosis. Abundant illustrations display the characteristic features of the most important disease entities. Rather than being yet another encyclopedic work of reference, this volume takes a fresh approach as it resembles a series of stimulating seminars employing exemplary case material to highlight, illustrate, and succinctly discuss the key points. To this end, the reader will be guided through a series of paired cases that pose a significant diagnostic challenge. By comprehensively comparing and contrasting two related entities, each such chapter will illuminate an intellectual pathway through which an important diagnostic puzzle can be solved. To broaden the differential diagnosis even further, additional illustrative cases are added to each discussion. Algorithms and tables summarize key points. Clinically relevant, up-to-date references will be provided to guide further study. Written by experts in the field, this novel text will be of great value to surgical pathologists in practice and dermatologists as well as residents and fellows training in these specialties.

Christopher R. Shea: author's other books


Who wrote Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management? Find out the surname, the name of the author of the book and a list of all author's works by series.

Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management — read online for free the complete book (whole text) full work

Below is the text of the book, divided by pages. System saving the place of the last page read, allows you to conveniently read the book "Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management" online for free, without having to search again every time where you left off. Put a bookmark, and you can go to the page where you finished reading at any time.

Light

Font size:

Reset

Interval:

Bookmark:

Make
Part I
Introductory Chapters
Springer Science+Business Media New York 2015
Christopher R. Shea , Jon A. Reed and Victor G. Prieto (eds.) Pathology of Challenging Melanocytic Neoplasms 10.1007/978-1-4939-1444-9_1
1. Gross Prosection of Melanocytic Lesions
Jon A. Reed 1, 2 , Victor G. Prieto 3 and Christopher R. Shea 4
(1)
Baylor College of Medicine, 1 Baylor Plaza, Houston, TX 77030, USA
(2)
CellNetix Pathology & Laboratories, 1124 Columbia St., Suite 200, Seattle, WA 98117, USA
(3)
MD Anderson Cancer Center, University of Houston, 1515 Holcombe Blvd., Unit 85, Houston, TX 77030, USA
(4)
University of Chicago Medicine, 5841 S. Maryland Ave., MC 5067, L502, Chicago, IL 60637, USA
Jon A. Reed
Email:
Email:
Introduction
Accurate diagnosis of a challenging melanocytic neoplasm requires adequate (i.e., representative) clinical sampling of the lesion and careful microscopic examination of histological sections. Adequate microscopic examination of a lesion in turn depends on the proper transport, gross prosection, and tissue processing of the clinical specimen to assure optimum histology. These technical considerations also are important to preserve tissues for additional immunohistochemical or molecular diagnostic studies if required. As such, tissue handling is becoming an increasingly important variable as newer, more sophisticated molecular tests are developed to provide better diagnostic and prognostic information and to identify specific aberrations with actionable treatment options for individual patients. Many of the newer molecular diagnostic tests have been developed for use on formalin-fixed, paraffin-embedded tissues []. The objective of this chapter is to summarize current best practice techniques for the gross examination and prosection of formalin-fixed, paraffin-embedded cutaneous specimens containing melanocytic lesions.
Biopsy/Surgical Techniques
Proper handling of tissues containing melanocytic neoplasms requires an understanding of the types of specimens commonly submitted to the laboratory for pathologic examination. Most cutaneous specimens can be divided into two broad categories: diagnostic biopsies and therapeutic excisions. Cutaneous melanocytic lesions often are sampled first by shave biopsy or punch biopsy to establish a diagnosis. Subsequent (or primary) therapeutic procedures may include deeper shaves (tangential excisions/saucerizations), larger punches, and deeper elliptical or cylindrical surgical excisions. Melanocytic lesions are seldom intentionally sampled by curettage because of diagnostic limitations related to tissue orientation in histological sections.
A considerable body of literature already exists concerning the benefits and limitations of frozen section diagnosis of melanocytic lesions treated by Mohs micrographic surgery in a clinical office setting and will not be further discussed in this introductory chapter. Similarly, diagnostic and therapeutic procedures (such as needle core biopsies, fine needle aspiration cytology, surgical de-bulking procedures, and regional lymphadenectomies) commonly used to evaluate extracutaneous deposits of metastatic melanomas are not included. The handling of sentinel lymph node biopsies related to the challenging differential diagnosis of metastatic melanoma versus capsular nevus is addressed in Chap..
Punch Biopsies/Punch Excisions
Punch biopsies of skin produce a cylindrical portion of tissue that is oriented perpendicular to the epidermal surface. Punch biopsies often are performed to diagnose inflammatory dermatoses because they allow histological examination of epidermis, superficial and deep dermis, and possibly superficial subcutaneous adipose tissue. Similarly, a punch biopsy may be used for a melanocytic lesion that is suspected of having a deeper dermal or subcutaneous component. Larger punches also may used to completely remove a lesion that was previously biopsied by a smaller diameter punch biopsy or by a superficial shave biopsy (see below).
Small punch biopsies should be used with caution when sampling a melanocytic neoplasm []. A single small punch biopsy may yield a nonrepresentative sample form a large atypical melanocytic neoplasm. Multiple smaller punches may be used; however, to map peripheral spread of a large lesion such as lentigo maligna that has previously been diagnosed by another biopsy.
Handling of a punch biopsy is straightforward. Punches intended to completely remove a lesion should be marked with indelible ink along the entire dermal surface including periphery and base, sparing only the epidermal surface. Specimens larger than 3 mm in diameter are bisected, and very large specimens, serially sectioned along the long axis (i.e., perpendicular to the epidermal surface). After routine tissue processing, histological sections cut perpendicular to the epidermis will thus have a perimeter marked by ink that defines the surgical margin (Fig. ).
Fig 11 Microscopic evaluation of peripheral margins a Melanoma in situ - photo 1
Fig. 1.1
Microscopic evaluation of peripheral margins. ( a ) Melanoma in situ involving the inked peripheral margin of a specimen (20). ( b ) Atypical nevus excised with a margin of un-involved skin (10)
Shave Biopsies/Shave Excisions (Saucerizations, Tangential Excisions)
Shave biopsies represent a sampling of epidermis and superficial dermis taken in a plane parallel to the epidermal surface. Deeper shaves may include superficial reticular dermis, but subcutis is almost never sampled by this technique. Deeper shave biopsies (tangential excisions/saucerizations) intended to completely remove a lesion are marked with indelible ink along the entire margin sparing only the epidermal surface. Depending on the size, shave biopsies may be bisected along the long axis or serially sectioned. The tissue is then embedded on edge so that the inked peripheral and deep margin is entirely represented in the histological section. Larger shaves may be divided between cassettes so that the tip (third dimension) margins can be evaluated independent of sections from the middle of the lesion.
Elliptical (and Cylindrical) Excisions
Excisions are, by definition, specimens intended to excise a lesion. As such, assessment and reporting of margins is usually required. Most excisions are elliptical; however, cylindrical specimens may be taken from certain anatomic sites where optimum lines of surgical closure are not clinically evident prior to the procedure. In this case, additional detached tips (dog ears) may be submitted separately, and should be treated as true tip margins. Larger excisional specimens often are oriented to identify a specific anatomic site on the patient such that a positive margin may be treated locally and less aggressively. Any surface lesion should be described noting its size, circumscription, color(s), and proximity to the peripheral margins.
Un-oriented specimens are marked with indelible ink along the entire peripheral and deep surgical margin similar to a shave biopsy. The ellipse (or cylinder) is then serially sectioned along the entire specimen (bread-loafed) to produce parallel sections perpendicular to the epidermal surface. Each section should be no greater than 23 mm in thickness to facilitate optimum tissue fixation and to allow examination of a larger area of surgical margin. Any lesion present on the cut surface should be noted, especially satellite lesions outside of the prior biopsy site in larger excisions.
Next page
Light

Font size:

Reset

Interval:

Bookmark:

Make

Similar books «Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management»

Look at similar books to Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management. We have selected literature similar in name and meaning in the hope of providing readers with more options to find new, interesting, not yet read works.


Reviews about «Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management»

Discussion, reviews of the book Pathology of Challenging Melanocytic Neoplasms: Diagnosis and Management and just readers' own opinions. Leave your comments, write what you think about the work, its meaning or the main characters. Specify what exactly you liked and what you didn't like, and why you think so.