Swanson Neil A, Lee Ken K, Gorman Annalisa, Lee Han N
Department of Dermatology, Oregon Health & Science University, 3181 SW Sam Jackson Park Road, Mailcode OP06, Portland, OR 97201, USA.
Dermatol Clin. 2002 Oct;20(4):677-80. doi: 10.1016/s0733-8635(02)00025-6.
The biopsy of a suspicious pigmented lesion is critical to establishing a correct and complete diagnosis. It allows the dermatopathologist accurately to diagnose melanoma and to gauge maximum depth of invasion (and other histologic criterion). This, in turn, influences the extent of further necessary surgery or other adjuvant therapy. Furthermore, choosing the appropriate biopsy technique provides adequate cosmetic results, bearing in mind that the excisional technique is ideal because it removes the suspicious lesion en toto. Excisional biopsies should extend to the subcutaneous fat by means of a punch biopsy, a fusiform ellipse, or a saucerization. Incisional biopsies can be performed in certain circumstances, but should be done so with caution because sampling error may lead to missed diagnosis or inaccurate histologic criterion, such as depth.
对可疑色素沉着病变进行活检对于做出正确和完整的诊断至关重要。它能让皮肤病理学家准确诊断黑色素瘤并评估最大浸润深度(以及其他组织学标准)。这进而会影响进一步必要手术或其他辅助治疗的范围。此外,选择合适的活检技术能带来良好的美容效果,要记住切除技术是理想的,因为它能将可疑病变整体切除。切除活检应通过打孔活检、梭形椭圆形切口或碟形切除延伸至皮下脂肪。在某些情况下可进行切开活检,但应谨慎操作,因为取样误差可能导致漏诊或组织学标准不准确,如深度判断错误。