Morphometric discrimination of melanoma in situ of sun-damaged skin from chronically sun-damaged skin

Acker, Scott M.; Nicholson, James H.; Rust, Philip F.; Maize, John C.

doi:10.1016/s0190-9622(98)70082-9

Cited by 48 publications

(41 citation statements)

References 24 publications

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“…[43] With respect to automated quantification of microscopic information, nuclear morphometry is clearly a useful diagnostic tool in several settings. [1617181920212627] Automated quantification of microscopic information can uncover differences not necessarily captured visually;[44] and in reverse, qualitative morphological impressions are hard to compare or quantify. Here, we applied a nuclear circularity-based classifier to confirm a morphological impression of the variation in nuclear shapes between SM and DM.…”

Section: Discussionmentioning

confidence: 99%

“…human epidermal growth factor receptor 2-immunolabeling intensity) has become part of the repertoire for many diagnostic pathologists. [11131415] Despite various studies reporting on classification of morphometric[3] and in particular nuclear features,[161718192021] these shape-based quantification tools are not widely established in routine surgical pathology. In contrast, there are several recent basic-science examples of clever combinations of computational morphometry, molecular-genetic, and functional methods.…”

Section: Introductionmentioning

confidence: 99%

“…[12022232425] The lack of adoption in the routine diagnostic setting is particularly surprising given that morphometry can provide clinically relevant information[8172026] and is able to solve diagnostic problems. [1617181920212627] Due to the drastically increasing performance and adoption of imaging solutions in pathology, one key opportunity of digital pathology quantitative shape-assessment, is largely unexplored.…”

Section: Introductionmentioning

confidence: 99%

“…Thus, diagnostic distinction of SM and DM can be challenging. Nuclear-morphometric studies have been conducted in a variety of melanocytic lesions,[1619293031] to our knowledge, however, the spectrum of nuclear shapes in SM and DM has not been studied. Using freely available computational image analysis tools, we carried out a quantitative examination of the nuclear circularity in our SM/DM cohort.…”

Section: Introductionmentioning

confidence: 99%

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A nuclear circularity-based classifier for diagnostic distinction of desmoplastic from spindle cell melanoma in digitized histological images

Schöchlin

Weissinger

Brandes

et al. 2014

Journal of Pathology Informatics

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Context:Distinction of spindle cell melanoma (SM) and desmoplastic melanoma (DM) is clinically important due to differences in metastatic rate and prognosis; however, histological distinction is not always straightforward. During a routine review of cases, we noted differences in nuclear circularity between SM and DM.Aim:The primary aim in our study was to determine whether these differences in nuclear circularity, when assessed using a basic ImageJ-based threshold extraction, can serve as a diagnostic classifier to distinguish DM from SM.Settings and Design:Our retrospective analysis of an established patient cohort (SM n = 9, DM n = 9) was employed to determine discriminatory power.Subjects and Methods:Regions of interest (total n = 108; 6 images per case) were selected from scanned H and E-stained histological sections, and nuclear circularity was extracted and quantified by computational image analysis using open source tools (plugins for ImageJ).Statistical Analysis:Using analysis of variance, t-tests, and Fisher's exact tests, we compared extracted quantitative shape measures; statistical significance was defined as P < 0.05.Results:Classifying circularity values into four shape categories (spindled, elongated, oval, round) demonstrated significant differences in the spindled and round categories. Paradoxically, DM contained more spindled nuclei than SM (P = 0.011) and SM contained more round nuclei than DM (P = 0.026). Performance assessment using a combined shape-classification of the round and spindled fractions showed 88.9% accuracy and a Youden index of 0.77.Conclusions:Spindle cell melanoma and DM differ significantly in their nuclear morphology with respect to fractions of round and spindled nuclei. Our study demonstrates that quantifying nuclear circularity can be used as an adjunct diagnostic tool for distinction of DM and SM.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A nuclear circularity-based classifier for diagnostic distinction of desmoplastic from spindle cell melanoma in digitized histological images

Schöchlin

Weissinger

Brandes

et al. 2014

Journal of Pathology Informatics

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“…Zalla et al 40 primarily utilize MART-1/Melan-A during MMS, but report that occasionally they rely upon a negative HMB-45 stain to determine an end point when encountering equivocal sections with MART-1. In a morphometric analysis, Acker et al 82 noted that "melanocytes of sun-damaged skin tend to have a larger nucleus as the number of melanocytes decreases, whereas in MIS the opposite was true." In light of our patient in whom lack of staining with HMB-45 led to misdiagnosis and progression to a deeply invasive melanoma, we have decided not to exclude foci evident with MART-1 based on lack of staining with HMB-45 or S-100.…”

Section: Case Report and Discussionmentioning

confidence: 99%

Mohs Micrographic Surgery for Melanoma: A Case Series, a Comparative Study of Immunostains, an Informative Case Report, and a Unique Mapping Technique

et al. 2002

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MM, especially MIS on the head and neck, often exhibits an asymmetric growth pattern, making it quite suitable for treatment with MMS. The use of MART-1 immunostain may improve the diagnostic accuracy of Mohs surgeons. We believe that HMB-45 should not be used to rule out the diagnosis of MIS in equivocal sections because of its inferior sensitivity. We introduce a new mapping technique as an adjunctive measure to aid in the clinicopathologic evaluation of perilesional skin.

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Melanocytes in Long-standing Sun-Exposed Skin

Hendi¹,

Brodland²,

Zitelli³

2006

Arch Dermatol

105

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To help distinguish early melanoma from normal sun-damaged skin by quantifying the density, confluence, and depth of follicular penetration of melanocytes in long-standing sun-exposed skin of the face and neck. Design: Case series. Setting: Referral center. Patients: Random selection of 149 patients undergoing Mohs surgery for basal cell and squamous cell carcinomas of the face and neck. Intervention: Frozen-section slides were made from long-standing sun-exposed normal skin and stained with MART-1 (melanoma antigen recognized by T cells 1 staining) immunostain. Main Outcome Measures: The number, confluence, and depth of penetration of melanocytes along the follicular epithelium were quantified per highpower field (original magnification ϫ400, equivalent to 0.5 mm of skin). Confluence was categorized by the number of adjacent melanocytes (none, 0-1; mild, 2; moderate, 3-6; and severe, Ͼ6). Results: The mean number of melanocytes per highpower field was 15.6 (range, 6-29). Confluence was severe in 1.0% of the specimens, moderate in 34.0%, mild in 54.0%, and absent in 11.0%. Focal areas of increased melanocyte density occurred in 24.2% of the specimens; in these areas, the mean number of melanocytes per high-power field was 20.3 (range, 7-36) and the confluence of melanocytes was severe in 13.0%, moderate in 50.0%, and mild in 37.0%. The mean depth of follicular epithelium penetration by melanocytes was 0.38 mm. Pagetoid spread and nesting of melanocytes were not seen. Nonspecific scattered MART-1-staining dermal cells were in half of the slides. Conclusions: Melanocytes in long-standing sunexposed skin have an increased density and a confluence that is often moderate (3-6 adjacent melanocytes), but they do not exhibit pagetoid spread or nesting. Nonspecific MART-1-staining dermal cells should not be interpreted as invasive melanoma.

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Morphometric discrimination of melanoma in situ of sun-damaged skin from chronically sun-damaged skin

Cited by 48 publications

References 24 publications

A nuclear circularity-based classifier for diagnostic distinction of desmoplastic from spindle cell melanoma in digitized histological images

A nuclear circularity-based classifier for diagnostic distinction of desmoplastic from spindle cell melanoma in digitized histological images

Mohs Micrographic Surgery for Melanoma: A Case Series, a Comparative Study of Immunostains, an Informative Case Report, and a Unique Mapping Technique

Melanocytes in Long-standing Sun-Exposed Skin

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