A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series
Purpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar c...
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Frontiers Media S.A.
2021-08-01
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| Online Access: | https://www.frontiersin.org/articles/10.3389/fmed.2021.681668/full |
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| author | Panpan Liu Panpan Liu Panpan Liu Juan Su Juan Su Juan Su Xuanwei Zheng Xuanwei Zheng Xuanwei Zheng Mingliang Chen Mingliang Chen Mingliang Chen Xiang Chen Xiang Chen Xiang Chen Jie Li Jie Li Jie Li Cong Peng Cong Peng Cong Peng Yehong Kuang Yehong Kuang Yehong Kuang Wu Zhu Wu Zhu Wu Zhu |
| author_facet | Panpan Liu Panpan Liu Panpan Liu Juan Su Juan Su Juan Su Xuanwei Zheng Xuanwei Zheng Xuanwei Zheng Mingliang Chen Mingliang Chen Mingliang Chen Xiang Chen Xiang Chen Xiang Chen Jie Li Jie Li Jie Li Cong Peng Cong Peng Cong Peng Yehong Kuang Yehong Kuang Yehong Kuang Wu Zhu Wu Zhu Wu Zhu |
| author_sort | Panpan Liu |
| collection | DOAJ |
| description | Purpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar clinical manifestations.Patients and Methods: We studied 4,561 consecutive patients with a clinical diagnosis of melanocytic nevi from 2014 to 2019. We compared the clinical diagnosis with the histopathological diagnosis to establish a histopathological concordance rate and then investigated the effects of clinical characteristics and the reasons for removal on misclassification.Results: Among 4,561 patients who were clinically diagnosed with melanocytic nevi, the overall histopathological concordance rate was 82.11% (3,745 of 4,561 patients), while the histopathological discordance rate was 17.89% (816 of 4,561 patients). The histopathological concordance included 90.25% common acquired melanocytic nevi (3,380 of 3,745 patients) and 9.75% other benign melanocytic neoplasms (365 of 3,745 patients). The most common diagnostic change was to seborrheic keratosis (n = 470, 10.30%), followed by basal cell carcinoma (n = 64, 1.40%), vascular tumor (n = 53, 1.16%), fibroma (n = 43, 0.94%), epidermoid cyst (n = 34, 0.75%), wart (n = 30, 0.66%), melanoma (n = 24, 0.53%), Bowen's disease (n = 16, 0.35%), squamous cell carcinoma (n = 4, 0.09%), keratoacanthoma (n = 2, 0.04%), and other neoplasms (n = 76, 1.67%). Male sex, old age, location of the lesion, and the reasons for removal have a potential effect on misclassification. The percentages of misclassified lesions on the trunk and limbs and the perineum and buttocks were higher than those in lesions without a change in diagnosis. Importantly, locations of lesions on the head and neck were significantly related to a change in diagnosis to non-melanoma skin cancer, while locations on the hands and feet were significantly related to a change in diagnosis to melanoma. In addition to a typical clinical features, removal due to lesion changes or repeated stimulation was significantly associated with a change in diagnosis to melanoma.Conclusions: Our study emphasizes the clinical differential diagnosis of melanocytic nevi, especially the possibility of malignant tumors. The occurrence of clinical features associated with clinicopathological discordance should raise the clinical suspect and be carefully differentiated from malignant tumors. |
| first_indexed | 2024-12-14T19:09:04Z |
| format | Article |
| id | doaj.art-6b9792fab79c4b94b4b0d0e024c32a54 |
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| language | English |
| last_indexed | 2024-12-14T19:09:04Z |
| publishDate | 2021-08-01 |
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| series | Frontiers in Medicine |
| spelling | doaj.art-6b9792fab79c4b94b4b0d0e024c32a542022-12-21T22:50:46ZengFrontiers Media S.A.Frontiers in Medicine2296-858X2021-08-01810.3389/fmed.2021.681668681668A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective SeriesPanpan Liu0Panpan Liu1Panpan Liu2Juan Su3Juan Su4Juan Su5Xuanwei Zheng6Xuanwei Zheng7Xuanwei Zheng8Mingliang Chen9Mingliang Chen10Mingliang Chen11Xiang Chen12Xiang Chen13Xiang Chen14Jie Li15Jie Li16Jie Li17Cong Peng18Cong Peng19Cong Peng20Yehong Kuang21Yehong Kuang22Yehong Kuang23Wu Zhu24Wu Zhu25Wu Zhu26Department of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaDepartment of Dermatology, Xiangya Hospital, Central South University, Changsha, ChinaHunan Key Laboratory of Skin Cancer and Psoriasis, Changsha, ChinaHunan Engineering Research Center of Skin Health and Disease, Changsha, ChinaPurpose: Melanocytic nevi are common cutaneous lesions. This study aimed to demonstrate the concordance and discordance between clinical and histopathological diagnoses of melanocytic nevi and the importance of histological evaluation in differentiating malignant lesions from diseases with similar clinical manifestations.Patients and Methods: We studied 4,561 consecutive patients with a clinical diagnosis of melanocytic nevi from 2014 to 2019. We compared the clinical diagnosis with the histopathological diagnosis to establish a histopathological concordance rate and then investigated the effects of clinical characteristics and the reasons for removal on misclassification.Results: Among 4,561 patients who were clinically diagnosed with melanocytic nevi, the overall histopathological concordance rate was 82.11% (3,745 of 4,561 patients), while the histopathological discordance rate was 17.89% (816 of 4,561 patients). The histopathological concordance included 90.25% common acquired melanocytic nevi (3,380 of 3,745 patients) and 9.75% other benign melanocytic neoplasms (365 of 3,745 patients). The most common diagnostic change was to seborrheic keratosis (n = 470, 10.30%), followed by basal cell carcinoma (n = 64, 1.40%), vascular tumor (n = 53, 1.16%), fibroma (n = 43, 0.94%), epidermoid cyst (n = 34, 0.75%), wart (n = 30, 0.66%), melanoma (n = 24, 0.53%), Bowen's disease (n = 16, 0.35%), squamous cell carcinoma (n = 4, 0.09%), keratoacanthoma (n = 2, 0.04%), and other neoplasms (n = 76, 1.67%). Male sex, old age, location of the lesion, and the reasons for removal have a potential effect on misclassification. The percentages of misclassified lesions on the trunk and limbs and the perineum and buttocks were higher than those in lesions without a change in diagnosis. Importantly, locations of lesions on the head and neck were significantly related to a change in diagnosis to non-melanoma skin cancer, while locations on the hands and feet were significantly related to a change in diagnosis to melanoma. In addition to a typical clinical features, removal due to lesion changes or repeated stimulation was significantly associated with a change in diagnosis to melanoma.Conclusions: Our study emphasizes the clinical differential diagnosis of melanocytic nevi, especially the possibility of malignant tumors. The occurrence of clinical features associated with clinicopathological discordance should raise the clinical suspect and be carefully differentiated from malignant tumors.https://www.frontiersin.org/articles/10.3389/fmed.2021.681668/fullmelanocytic nevimelanocytic diseasesmelanomadiagnosismisclassification |
| spellingShingle | Panpan Liu Panpan Liu Panpan Liu Juan Su Juan Su Juan Su Xuanwei Zheng Xuanwei Zheng Xuanwei Zheng Mingliang Chen Mingliang Chen Mingliang Chen Xiang Chen Xiang Chen Xiang Chen Jie Li Jie Li Jie Li Cong Peng Cong Peng Cong Peng Yehong Kuang Yehong Kuang Yehong Kuang Wu Zhu Wu Zhu Wu Zhu A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series Frontiers in Medicine melanocytic nevi melanocytic diseases melanoma diagnosis misclassification |
| title | A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series |
| title_full | A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series |
| title_fullStr | A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series |
| title_full_unstemmed | A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series |
| title_short | A Clinicopathological Analysis of Melanocytic Nevi: A Retrospective Series |
| title_sort | clinicopathological analysis of melanocytic nevi a retrospective series |
| topic | melanocytic nevi melanocytic diseases melanoma diagnosis misclassification |
| url | https://www.frontiersin.org/articles/10.3389/fmed.2021.681668/full |
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