Biopsy/surgical techniques

Pathology of challenging melanocytic neoplasms. Diagnosis and Management. Christopher R. Shea, Jon A. Reed, Victor G. Prieto (Editors). Springer (2015)

Proper handling of tissues containing melanocytic neoplasms requires an understanding of the types of specimens commonly submitted to the laboratory for pathologic examination. Most cutaneous specimens can be divided into two broad categories: diagnostic biopsies and therapeutic excisions. Cutaneous melanocytic lesions often are sampled first by shave biopsy or punch biopsy to establish a diagnosis. Subsequent (or primary) therapeutic procedures may include deeper shaves (tangential excisions/saucerizations), larger punches, and deeper elliptical or cylindrical surgical excisions. Melanocytic lesions are seldom intentionally sampled by curettage because of diagnostic limitations related to tissue orientation in histological sections.

A considerable body of literature already exists concerning the benefits and limitations of frozen section diagnosis of melanocytic lesions treated by Mohs micrographic surgery in a clinical office setting and will not be further discussed in this introductory chapter. Similarly, diagnostic and therapeutic procedures (such as needle core biopsies, fine needle aspiration cytology, surgical de-bulking procedures, and regional lymphadenectomies) commonly used to evaluate extracutaneous deposits of metastatic melanomas are not included. The handling of sentinel lymph node biopsies related to the challenging differential diagnosis of metastatic melanoma versus capsular nevus is addressed in Chap. 17.

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