Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma

Introduction. The differential diagnosis of lesions excised to exclude melanoma include a variety of benign and malignant melanocytic and non-melanocytic lesions. Objectives. We examined the variability between pathologists in diagnosing non-melanocytic lesions. Methods. As part of a larger...

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Autores principales:	Ian Katz, Tony Azzi, Alister Lilleyman, Blake O'Brien, Brian Schapiro, Curtis Thompson, Tarl Prow
Formato:	article
Lenguaje:	EN
Publicado:	Mattioli1885 2021
Materias:	melanoma seborrheic keratosis artificial intelligence AI large cell acanthoma diagnosis Dermatology RL1-803
Acceso en línea:	https://doaj.org/article/27845115fa58473cbd793fff0bc27c69
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spelling	oai:doaj.org-article:27845115fa58473cbd793fff0bc27c692021-11-15T15:16:17ZVariability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma10.5826/dpc.1104a942160-9381https://doaj.org/article/27845115fa58473cbd793fff0bc27c692021-10-01T00:00:00Zhttps://dpcj.org/index.php/dpc/article/view/1615https://doaj.org/toc/2160-9381 Introduction. The differential diagnosis of lesions excised to exclude melanoma include a variety of benign and malignant melanocytic and non-melanocytic lesions. Objectives. We examined the variability between pathologists in diagnosing non-melanocytic lesions. Methods. As part of a larger study prospectively examining the diagnosis of lesions excised to exclude melanoma in 198 patients at a primary care skin cancer clinic in Newcastle, Australia, we compared diagnosis made by 5 experienced dermatopathologists, of 44 non-melanocytic lesions in 44 patients aged 22-90. Results. Forty-four lesions (out of 217 in total) were non-melanocytic. Among the 5 pathologists who examined each case there was marked variability in the terminology used to diagnose each case. The most common variability was found between seborrheic keratosis, large cell acanthoma, solar lentigo, and lichenoid keratosis. The diagnosis made by the majority of the pathologists was deemed to be the reference diagnosis. Versus majority diagnosis, 4% of benign lesions were considered malignant, and 7% of malignant diagnoses were considered as benign. Conclusions. The different terminology adopted and lack of consensus in the diagnosis of these non-melanocytic lesions in this setting suggests that training AI systems using gold standards may be problematic. We propose a new management classification scheme called MOLEM (Management of Lesions Excised to exclude Melanoma) which expands the previously described MPATH-dx to include non-melanocytic lesions. Ian KatzTony AzziAlister LilleymanBlake O'BrienBrian SchapiroCurtis ThompsonTarl ProwMattioli1885articlemelanomaseborrheic keratosisartificial intelligenceAIlarge cell acanthomadiagnosisDermatologyRL1-803ENDermatology Practical & Conceptual (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	melanoma seborrheic keratosis artificial intelligence AI large cell acanthoma diagnosis Dermatology RL1-803
spellingShingle	melanoma seborrheic keratosis artificial intelligence AI large cell acanthoma diagnosis Dermatology RL1-803 Ian Katz Tony Azzi Alister Lilleyman Blake O'Brien Brian Schapiro Curtis Thompson Tarl Prow Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma
description	Introduction. The differential diagnosis of lesions excised to exclude melanoma include a variety of benign and malignant melanocytic and non-melanocytic lesions. Objectives. We examined the variability between pathologists in diagnosing non-melanocytic lesions. Methods. As part of a larger study prospectively examining the diagnosis of lesions excised to exclude melanoma in 198 patients at a primary care skin cancer clinic in Newcastle, Australia, we compared diagnosis made by 5 experienced dermatopathologists, of 44 non-melanocytic lesions in 44 patients aged 22-90. Results. Forty-four lesions (out of 217 in total) were non-melanocytic. Among the 5 pathologists who examined each case there was marked variability in the terminology used to diagnose each case. The most common variability was found between seborrheic keratosis, large cell acanthoma, solar lentigo, and lichenoid keratosis. The diagnosis made by the majority of the pathologists was deemed to be the reference diagnosis. Versus majority diagnosis, 4% of benign lesions were considered malignant, and 7% of malignant diagnoses were considered as benign. Conclusions. The different terminology adopted and lack of consensus in the diagnosis of these non-melanocytic lesions in this setting suggests that training AI systems using gold standards may be problematic. We propose a new management classification scheme called MOLEM (Management of Lesions Excised to exclude Melanoma) which expands the previously described MPATH-dx to include non-melanocytic lesions.
format	article
author	Ian Katz Tony Azzi Alister Lilleyman Blake O'Brien Brian Schapiro Curtis Thompson Tarl Prow
author_facet	Ian Katz Tony Azzi Alister Lilleyman Blake O'Brien Brian Schapiro Curtis Thompson Tarl Prow
author_sort	Ian Katz
title	Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma
title_short	Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma
title_full	Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma
title_fullStr	Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma
title_full_unstemmed	Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma
title_sort	variability in the histopathological diagnosis of nonmelanocytic lesions excised to exclude melanoma
publisher	Mattioli1885
publishDate	2021
url	https://doaj.org/article/27845115fa58473cbd793fff0bc27c69
work_keys_str_mv	AT iankatz variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma AT tonyazzi variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma AT alisterlilleyman variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma AT blakeobrien variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma AT brianschapiro variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma AT curtisthompson variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma AT tarlprow variabilityinthehistopathologicaldiagnosisofnonmelanocyticlesionsexcisedtoexcludemelanoma
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Variability in the Histopathological Diagnosis of Nonmelanocytic Lesions Excised to Exclude Melanoma

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