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[黑素细胞性皮肤病变的皮肤镜-病理相关性]

[Dermatoscopic-pathological correlation of melanocytic skin lesions].

作者信息

Kittler H

机构信息

Universitätsklinik für Dermatologie, Medizinische Universität Wien, Währinger Gürtel 18-20, 1090, Wien, Österreich.

出版信息

Hautarzt. 2018 Jul;69(7):528-535. doi: 10.1007/s00105-018-4204-8.

Abstract

There is no doubt that dermatopathology is the most important method to decide if a melanocytic lesion is benign or malignant; however, like most morphologic examinations, dermatopathology is subjective. A recent study demonstrated that the pathologic diagnosis of melanocytic skin lesions has a high variability. Reports with false-positive or false-negative diagnoses are relatively common. The pathologic examination of melanocytic lesions also has observer-independent limitations and one has to accept that some melanocytic lesions cannot be classified as benign or malignant with confidence by dermatopathology alone. If a confident diagnosis is not possible a dermatoscopic-pathologic correlation may be helpful. This, however, is only possible if dermatoscopic images are available and if the dermatopathologist knows how to interpret dermatoscopic structures. A dermatoscopic-pathologic correlation is not useful in all difficult melanocytic lesions but it should be considered in difficult flat pigmented lesions. In these cases dermatoscopy may provide even more important additional information than molecular findings.

摘要

毫无疑问,皮肤病理学是判定黑素细胞性病变是良性还是恶性的最重要方法;然而,与大多数形态学检查一样,皮肤病理学具有主观性。最近一项研究表明,黑素细胞性皮肤病变的病理诊断具有高度变异性。假阳性或假阴性诊断的报告相对常见。黑素细胞性病变的病理检查也存在与观察者无关的局限性,人们不得不承认,有些黑素细胞性病变仅靠皮肤病理学无法自信地分类为良性或恶性。如果无法做出可靠诊断,皮肤镜-病理相关性可能会有所帮助。然而,这只有在有皮肤镜图像且皮肤病理学家知道如何解读皮肤镜结构时才有可能。皮肤镜-病理相关性并非对所有困难的黑素细胞性病变都有用,但在困难的扁平色素性病变中应予以考虑。在这些情况下,皮肤镜可能比分子检测结果提供更重要的额外信息。

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