Dysplastic naevus in non-familial melanoma. A clinicopathological study of 101 cases

Grob, Jean-Jacques; Andrac, L; Romano, M; Davin, D.; Collet-Villette, A.-M.; Munoz, M.H.; Bonerandi, J. J.

doi:10.1111/j.1365-2133.1988.tb02591.x

Cited by 41 publications

(16 citation statements)

References 13 publications

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“…It is of interest that Grob et al [29) reported a prev alence of 18% histologically confirmed DMN in a series of nonfamilial melanoma patients, which is similar to the figure of 18.3% in our nonfamilial cases. Other authors have recorded somewhat higher frequencies, e.g.…”

Section: Discussionsupporting

confidence: 73%

Comparison of Nonfamilial and Familial Melanoma

et al. 1992

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There has been concern that individuals with nonfamilial melanoma and dysplastic melanocytic nevi (DMN) are not directly comparable to patients with hereditary melanoma and DMN. Because we have conducted a comprehensive study of nonfamilial melanoma over the past several years, we have addressed the above issue by directly comparing the characteristics of 145 nonfamilial patients, 6 patients with familial melanoma and the information available for familial melanoma in the literature. All 6 patients with familial melanoma had at least one first-degree blood relative with cutaneous melanoma. A large number of clinical and histologic variables were compared for both groups. Some pertinent variables included mean age at melanoma diagnosis 46.7 versus 52.3 years, mean Breslow thickness 2.11 versus 1.54 mm, mean total body nevi per patient 20.6 versus 18.3, mean total clinically atypical nevi per patient 2.0 versus 1.7 and total histologically confirmed DMN per group 22 (18.3%) versus 2 (33%), for patients with nonfamilial versus familial melanoma, respectively. No substantial differences were observed between the two groups. A review of the medical literature failed to reveal any quantitative data for melanocytic nevi, either clinical or histologic, at present that would allow distinction of patients with sporadic versus familial melanoma. We conclude that studies concerning the clinical characteristics of patients with DMN and nonfamilial melanoma are relevant to other persons with DMN including familial melanoma.

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Section: Discussionsupporting

confidence: 73%

Comparison of Nonfamilial and Familial Melanoma

et al. 1992

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“…The lack of correspondence between clinically dysplastic nevi and histologically dysplastic nevi has been well documented [18,29,30]. This is not surprising, given the lack of universally accepted criteria for dysplastic nevi.…”

Section: Discussionmentioning

confidence: 88%

Histopathologic Recognition and Grading of Dysplastic Melanocytic Nevi: An Interobserver Agreement Study.

Duncan¹,

Berwick²,

Bruijn³

et al. 1993

J Invest Dermatol

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Before the controversies surrounding dysplastic melanocytic nevi are resolved, dermatopathologists must be able to reliably distinguish dysplastic nevi from common acquired nevi and malignant melanoma. To establish whether grading of melanocytic dysplasia has any biologic relevance, dermatopathologists must be able to consistently recognize two or more grades of atypia. We studied the concordance among five dermatopathologists for recognition and grading of 60 nevomelanocytic lesions. Ten cases from each of the following categories of melanocytic proliferation were retrieved from the Massachusetts General Hospital files: 1) common melanocytic nevi, 2) melanocytic nevi with features of dysplastic nevi, 3) dysplastic nevi with slight cytologic atypia, 4) dysplastic nevi with moderate cytologic atypia, 5) dysplastic nevi with severe cytologic atypia, and 6) primary malignant melanoma. The slides were reviewed independently; no discussion of diagnostic criteria preceded the review. Overall concordance for diagnosing dysplastic nevi was 77%, with a kappa statistic of 0.55-0.84. Furthermore, in grading dysplastic nevi, experienced dermatopathologists had a concordance ranging from 35% to 58% (kappa value 0.38-0.47). Those with less experience in grading dysplastic nevi had a concordance of 16-65% (kappa value 0.05-0.24). The five observers in this study reliably distinguished dysplastic nevi from common acquired nevi and malignant melanoma. Further refinement of the criteria for grading of nevo-melanocytic dysplasia and experience in grading are critical for accuracy in subcategorization of dysplastic nevi. Consistent, reproducible subcategorization of dysplastic nevi is a requisite before the issue of biologic or prognostic relevance of grading (dysplastic nevi) can be addressed. This study supports the validity of existing criteria for the diagnosis of dysplastic nevi because the problems in diagnosis were at the limits of the spectrum, namely, discrimination of slightly atypical dysplastic nevi from common nevi and severely atypical dysplastic nevi from radial growth phase melanoma.

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“…Grob JJ et al (1988) [11] showed that the diagnosis of dysplastic naevi on the basis of clinical criteria alone is difficult and unreliable. Kwok YK et al (2001) [12], in their study on melanocytic naevi, reported a lack of clinicpathological concordance in dysplastic naevi.…”

Section: Discussionmentioning

confidence: 99%