Analysis of interobserver reproducibility in grading histological patterns of dysplastic nevi*

Abstract

BACKGROUNDDysplastic nevi are among the most important cutaneous melanoma simulators. They are important risk markers for this neoplasia and can be its potential precursors. Some authors found a statistically significant relationship between the degree of dysplasia and the risk for developing melanoma. However, reproducibility of grading criteria ranged from poor to fair in the researched articles. OBJECTIVETo test the reproducibility of the grading criteria proposed by Sagebiel et al. regarding dysplastic nevi. METHODSHistological specimens of 75 dysplastic nevi were graded, independently and in a blinded fashion, according to preestablished criteria, by a panel of 10 pathologists with different levels of experience. Diagnostic agreement was calculated using weighted kappa and intraclass correlation coefficients. RESULTSThe average of weighted kappa values was 0.13 for all observers, 0.12 for dermatopathologists, 0.18 for general pathologists and 0.05 for residents. Intraclass correlation coefficient values were 0.2 for all observers, 0.18 for dermatopathologists, 0.33 for general pathologists and 0.15 for residents. CONCLUSIONS:Histopathological grading for dysplastic nevi was not reproducible in this Brazilian series, so the criteria used are not a helpful histopathological parameter for clinicopathological correlation.

Risk of Subsequent Cutaneous Melanoma in Moderately Dysplastic Nevi Excisionally Biopsied but With Positive Histologic Margins

“…Our findings reinforce the need for regular skin examinations and patient education for those with a history of CM and/or 2 or more biopsied dysplastic nevi (at least 1 of which is moderately dysplastic). We conducted a central dermatopathologic review of dysplastic nevi, which ensured high adequacy of capture (87.5%) because of prior evidence demonstrating poor concordance between pathologists grading dysplastic nevi (ranging from 16% to 75% and κ coefficients of 0.055-0.71 [15][16][17][18] ). We did not report another κ coefficient because agreement statistics are used when trying to compare raters who have the same range of possible rankings.…”

Imaging Mass Spectrometry–Based Lipidomic Approach to Classification of Architectural Features in Nevi

“…Cutaneous melanocytic lesions represent a collection of heterogeneous entities, ranging from completely benign melanocytic nevi to malignant melanomas, the correct diagnosis of which is sometimes challenging (Brenn et al, 2012;Hawryluk et al, 2012;Nobre et al, 2013). Here, we explore the use of matrix-assisted laser desorption/ ionization imaging mass spectrometry (IMS) (MALDI-IMS) to monitor lipid disease-specific alterations in situ, linking histology with spatial distribution of molecules in tissues (Fernández et al, 2011;Gessel et al, 2014;Gustafsson et al, 2011;Stoeckli et al, 2001;Walch et al, 2008).…”

Is melanocyte density our last hope? Comparison of histologic features of photodamaged skin and melanoma in situ after staged surgical excision with concurrent scouting biopsies

“…Previous studies have implied high levels of diagnostic discordance and low levels of consensus among pathologists in interpretation of melanocytic lesions, insinuating the possibility of both over‐diagnosis and under‐diagnosis . Therefore, it is crucial to establish more objective and reproducible criteria that distinguish benign lesions on photodamaged skin from JLMP/MIS.…”