Histopathologic recognition of involved margins of lentigo maligna excised by staged excision: an interobserver comparison study

Archives of Dermatology
Scott R FlorellAntoinette F Hood

Abstract

To assess interobserver and intraobserver concordance for identifying positive and negative margins in staged excisions of lentigo maligna and lentigo maligna melanoma and to determine if control biopsy specimens are useful to improve concordance. Retrospective, randomized interobserver and intraobserver comparison study of archived pathologic specimens. The study was conducted in 3 phases, and slides were evaluated blindly and independently by 5 pathologists: in phase 1, all slides were randomized and diagnosed as positive or negative. In phase 2, every third slide was evaluated again and diagnosed as positive or negative. In phase 3, slides were organized into cases, allowing evaluation of each margin in the context of the positive control (tumor from the center of the lesion) and negative control (control biopsy specimen), if available. University referral center. A total of 301 glass microscopic slides from 27 patients who underwent staged excision for lentigo maligna or lentigo maligna melanoma from March 1997 to April 2001. Interobserver and intraobserver concordance between original diagnoses and study diagnoses rendered on all slides by 5 pathologists. Phase 1 and 3 agreement was moderate (kappa range, 0.4-0.5). Phase 2...Continue Reading

Citations

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