Melanoma maligno cutâneo: sistema de pontos (scoring system) para auxílio no diagnóstico histopatológico
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Data
2006-10-01
Autores
Veronese, Luiz Alberto [UNESP]
Corrente, José Eduardo [UNESP]
Marques, Mariângela Esther Alencar [UNESP]
Título da Revista
ISSN da Revista
Título de Volume
Editor
Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia
Resumo
INTRODUÇÃO: O diagnóstico histopatológico de algumas lesões melanocíticas pode ser muito difícil, mesmo para especialistas, mas há casos em que a dificuldade surge pela inadequada e subjetiva aplicação dos critérios diagnósticos. OBJETIVO: O objetivo deste estudo é desenvolver um método de aplicação sistemática desses critérios, atribuindo valores para os mais importantes. MATERIAL E MÉTODOS: Selecionaram-se os critérios mais relevantes para o diagnóstico de melanoma, atribuindo valores de 1 a 5 de acordo com sua importância. Foram escolhidos 101 casos de melanomas de tipo extensivo-superficial com menos de 2mm de espessura para análise comparativa com 33 lesões melanocíticas benignas (13 nevos de Spitz, seis de Reed, seis displásicos, três congênitos, três adquiridos, um combinado e um recorrente). RESULTADOS: A soma dos valores dados aos critérios (score) apresentou diferença significativa entre lesões malignas e benignas, mostrando que esse método pode ser útil ao patologista cirúrgico generalista em sua rotina diária. CONCLUSÃO: A aplicação objetiva e sistemática dos critérios histopatológicos pelo sistema de pontos (scoring system) pode ajudar o diagnóstico diferencial entre maligno e benigno em muitas lesões, porém não tendo o efeito desejado nas lesões melanocíticas de comportamento biológico indeterminado.
INTRODUCTION: The histopathological diagnosis of melanocytic lesions may be very difficult, even by experts within the field. The challenge can come from inaccurate and/or subjective application of the diagnosis criteria. AIM: The goal of this study was to develop a method of systematic application of histopathological criteria as a result of the most relevant microscopic characteristics. MATERIAL and METHODS: The most important criteria to diagnosing melanoma on histopathological bases were selected and given points ranging from 1 to 5 according to their relevance to the melanoma diagnosis. A total of 101 cases of extensive-superficial melanoma less than 2mm thick were comparatively analysed with 33 benign melanocytic lesions (thirteen Spitz nevi, six Reed nevi, six dysplastic nevi, three congenital nevi, three acquired nevi, one combined nevus and one recurrent nevus). RESULTS: The total amount of values obtained on histopathological criteria (scores) pointed out significant statistical differences between benign and malignant lesions, what makes this method useful for surgical pathologist in daily routines. CONCLUSION: The objective and systematic application of histopathological criteria by means of the scoring system may be helpful in the differential diagnosis between benign and malignant melanocytic neoplasms, but the approach was not able to distinguish melanocytic lesions of unknown biological behavior.
INTRODUCTION: The histopathological diagnosis of melanocytic lesions may be very difficult, even by experts within the field. The challenge can come from inaccurate and/or subjective application of the diagnosis criteria. AIM: The goal of this study was to develop a method of systematic application of histopathological criteria as a result of the most relevant microscopic characteristics. MATERIAL and METHODS: The most important criteria to diagnosing melanoma on histopathological bases were selected and given points ranging from 1 to 5 according to their relevance to the melanoma diagnosis. A total of 101 cases of extensive-superficial melanoma less than 2mm thick were comparatively analysed with 33 benign melanocytic lesions (thirteen Spitz nevi, six Reed nevi, six dysplastic nevi, three congenital nevi, three acquired nevi, one combined nevus and one recurrent nevus). RESULTS: The total amount of values obtained on histopathological criteria (scores) pointed out significant statistical differences between benign and malignant lesions, what makes this method useful for surgical pathologist in daily routines. CONCLUSION: The objective and systematic application of histopathological criteria by means of the scoring system may be helpful in the differential diagnosis between benign and malignant melanocytic neoplasms, but the approach was not able to distinguish melanocytic lesions of unknown biological behavior.
Descrição
Palavras-chave
Melanoma, Sistema de score, Diagnóstico diferencial, Nevo de Spitz, Melanoma, Scoring system, Differential diagnosis, Spitz nevus
Como citar
Jornal Brasileiro de Patologia e Medicina Laboratorial. Sociedade Brasileira de Patologia ClínicaSociedade Brasileira de PatologiaSociedade Brasileira de Citopatologia, v. 42, n. 5, p. 375-383, 2006.