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Histopathological diagnostics of malignant melanoma in accordance with the recent AJCC classification 2009: Review of the literature and recommendations for general practice
Author(s) -
Garbe Claus,
Eigentler Thomas K.,
Bauer Jürgen,
BlödornSchlicht Norbert,
Fend Falko,
Hantschke Markus,
Kurschat Peter,
Kutzner Heinz,
Metze Dieter,
Preßler Harald,
Reusch Michael,
Röcken Martin,
Stadler Rudolf,
Tronnier Michael,
Yazdi Amir,
Metzler Gisela
Publication year - 2011
Publication title -
jddg: journal der deutschen dermatologischen gesellschaft
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.463
H-Index - 60
eISSN - 1610-0387
pISSN - 1610-0379
DOI - 10.1111/j.1610-0387.2011.07714.x
Subject(s) - medicine , melanoma , sentinel node , sentinel lymph node , mitotic index , biopsy , pathology , dermatology , radiology , cancer , mitosis , cancer research , breast cancer , biology , microbiology and biotechnology
Summary Background: TNM classifications are the basis for diagnostic and therapeutic procedures in oncology. Histopathological reports have to enable a proper indexing of tumor specific findings into recent classifications. Methods: A systematic review of the literature was performed to identify reports dealing with the assessment of mitotic rate and the processing and evaluation of sentinel node biopsies in malignant melanoma. On the basis of this review an expert panel of dermatopathologists and general pathologists discussed and agreed recommendations for general practice. Results: Following recommendations were agreed with a broad consensus (93–100 % agreement): The determination of the mitotic rate in primary melanoma is performed on HE slides. The evaluation of an area of 1 mm 2 is sufficient. Only dermal mitoses are considered. The counted number of mitoses is provided as an integer value. The mitotic rate shall be determined in primary melanomas of ≤1.00 mm vertical tumor thickness according to the hot‐spot method and provided as an integer value in relation to an area of 1 mm 2 . The determination of the mitotic rate in the case of thicker primary melanomas is desirable. In general, for the evaluation of each sentinel lymph node, 4 slides should be prepared. For diagnostic purposes, immunohistochemistry (preferably with antibodies against S100ß, Melan A and HMB‐45) should be performed in addition to HE staining. The pathology report should provide information about micro‐metastases and their longest extension (one‐tenth of a millimeter). Conclusions: These recommendations are suitable for standardizing the histopathological diagnosis of malignant melanoma and for providing a common basis for clinical decisions and scientific research.