SPECIAL ARTICLES   

Giornale Italiano di Dermatologia e Venereologia 2002 February;137(1):61-4

Copyright © 2002 EDIZIONI MINERVA MEDICA

language: Italian

Pathological report in melanoma: comments on Guidelines proposed by the C.N.R.

Urso C.

Ospedale S. M. Annunziata - Azienda Sanitaria di Firenze Sezione Dermatopatologia

The guidelines for histological reporting of melanoma, published by the Consiglio Nazionale delle Ricerche (Italy) (C.N.R.) in 2000, are analyzed. These guidelines propose that the histological reports should contain some minimal (obligatory) requisites (diagnosis of melanoma, specifying if it is invasive and the phase of growth, hystotipe, thickness, regression, distance of the tumor from the resection margins), some “recommended” elements (Clark’s level, ulceration, lymphocytic infiltrate, vascular invasion, neutropism, mitotic index) and finally some “optional” features (cytologic type, pigmentation). The analysis of the text shows that the C.N.R scheme contains several conceptual, terminological and methodological details which make it hardly applicable in the light of new available data and in the respect of the new TNM classification, which will be in force in 2002. The more questionable elements in the text are: 1) ulceration, which was not considered among the obligatory requisites, despite it is the most important prognostic factor after thickness; 2) Clark’s level, which was not considered among obligatory elements, although it is necessary for staging thin melanomas (<1 mm); 3) phases of growth, considered among the obligatory elements, although their prognostic value is still controversial.