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Routine Clinical-Pathologic Correlation of Pigmented Skin Tumors Can Influence Patient Management.

Longo C, Piana S, Lallas A, Moscarella E, Lombardi M, Raucci M, Pellacani G, Argenziano G - PLoS ONE (2015)

Bottom Line: Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing.Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.

View Article: PubMed Central - PubMed

Affiliation: Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.

ABSTRACT

Background: Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice.

Aim of the study: In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center.

Results: Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.

Conclusion: In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.

No MeSH data available.


Related in: MedlinePlus

Workflow for the management of atypical melanocytic lesions in our tertiary referral center.When the histopathologic report is rendered, the clinician reviews the case in light of the clinical-dermoscopic pictures. Cases for which a good clinico-pathologic correlation is missing are jointly reviewed by clinicians and pathologists combining all relevant clinical and histopathologic data including clinical-dermoscopic images. A consensus diagnosis is finally reached and the patient treated accordingly.
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pone.0136031.g001: Workflow for the management of atypical melanocytic lesions in our tertiary referral center.When the histopathologic report is rendered, the clinician reviews the case in light of the clinical-dermoscopic pictures. Cases for which a good clinico-pathologic correlation is missing are jointly reviewed by clinicians and pathologists combining all relevant clinical and histopathologic data including clinical-dermoscopic images. A consensus diagnosis is finally reached and the patient treated accordingly.

Mentions: After the excision of a skin lesion, the clinician fills the referral sheet with anagraphic data, site of the lesion and reports his/her clinical diagnosis. When the histopathologic report is rendered, the clinician reviews the case in light of the clinical-dermoscopic pictures. Cases for which a good clinico-pathologic correlation is missing are jointly reviewed by the referral clinicians and the referral dermatopathologist combining all relevant clinical and histologic data including clinical-dermoscopic images and a picture selection of histopathologic slides. A final consensus diagnosis is then reached in light of the case discussion (Fig 1).


Routine Clinical-Pathologic Correlation of Pigmented Skin Tumors Can Influence Patient Management.

Longo C, Piana S, Lallas A, Moscarella E, Lombardi M, Raucci M, Pellacani G, Argenziano G - PLoS ONE (2015)

Workflow for the management of atypical melanocytic lesions in our tertiary referral center.When the histopathologic report is rendered, the clinician reviews the case in light of the clinical-dermoscopic pictures. Cases for which a good clinico-pathologic correlation is missing are jointly reviewed by clinicians and pathologists combining all relevant clinical and histopathologic data including clinical-dermoscopic images. A consensus diagnosis is finally reached and the patient treated accordingly.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4556521&req=5

pone.0136031.g001: Workflow for the management of atypical melanocytic lesions in our tertiary referral center.When the histopathologic report is rendered, the clinician reviews the case in light of the clinical-dermoscopic pictures. Cases for which a good clinico-pathologic correlation is missing are jointly reviewed by clinicians and pathologists combining all relevant clinical and histopathologic data including clinical-dermoscopic images. A consensus diagnosis is finally reached and the patient treated accordingly.
Mentions: After the excision of a skin lesion, the clinician fills the referral sheet with anagraphic data, site of the lesion and reports his/her clinical diagnosis. When the histopathologic report is rendered, the clinician reviews the case in light of the clinical-dermoscopic pictures. Cases for which a good clinico-pathologic correlation is missing are jointly reviewed by the referral clinicians and the referral dermatopathologist combining all relevant clinical and histologic data including clinical-dermoscopic images and a picture selection of histopathologic slides. A final consensus diagnosis is then reached in light of the case discussion (Fig 1).

Bottom Line: Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing.Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.

View Article: PubMed Central - PubMed

Affiliation: Dermatology and Skin Cancer Unit, Arcispedale Santa Maria Nuova-IRCCS, Reggio Emilia, Italy.

ABSTRACT

Background: Several studies have demonstrated the benefit of integrating clinical with pathologic information, to obtain a confident diagnosis for melanocytic tumors. However, all those studies were conducted retrospectively and no data are currently available about the role of a clinical-pathologic correlation approach on a daily basis in clinical practice.

Aim of the study: In our study, we evaluated the impact of a routine clinical-pathologic correlation approach for difficult skin tumors seen over 3 years in a tertiary referral center.

Results: Interestingly, a re-appraisal was requested for 158 out of 2015 (7.7%) excised lesions because clinical-pathologic correlation was missing. Of note, in 0.6% of them (13 out of 2045) the first histologic diagnosis was revised in the light of clinical information that assisted the Pathologist to re-evaluate the histopathologic findings that might be bland or inconspicuous per se.

Conclusion: In conclusion, our study demonstrated that an integrated approach involving clinicians and pathologists allows improving management of selected patients by shifting from a simply disease-focused management (melanoma versus nevus) to a patient-centered approach.

No MeSH data available.


Related in: MedlinePlus