Dysplastic nevus other diagnostic studies

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2]

Overview

When an atypical mole has been identified, a biopsy takes place in order to best diagnose it. Local anesthetic is used to numb the area, then the mole is biopsied. The biopsy material is then sent to a laboratory to be evaluated by a Pathologist.

Biopsy

Patients who have lesions suspected to be melanoma should always be biopsied.^[1]
An excisional biopsy (either elliptical, punch, or saucerization) of the thickest portion of the lesion with 1-3 mm margins is recommended.^[1]
Shave biopsy is acceptable only when the index of suspicion for melanoma is low.^[1]
The following should be reported when a biopsy is being reported:^[1]

Location
Regression
Tumor infiltrating lymphocytes
Breslow’s depth and vertical growth phase
Histologic ulceration
Clark level
Angiolymphatic invasion
Neurotropism
Histologic subtype

References

↑ ^1.0 ^1.1 ^1.2 ^1.3 Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A; et al. (2013). “Melanoma, version 2.2013: featured updates to the NCCN guidelines”. J Natl Compr Canc Netw. 11 (4): 395–407. PMID 23584343.

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[pmid23584343-1] 1.0 ^1.1 ^1.2 ^1.3 Coit DG, Andtbacka R, Anker CJ, Bichakjian CK, Carson WE, Daud A; et al. (2013). “Melanoma, version 2.2013: featured updates to the NCCN guidelines”. J Natl Compr Canc Netw. 11 (4): 395–407. PMID 23584343.

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