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Interobserver reproducibility of histological features in cutaneous malignant melanoma

¹ Dermatopathology Section, S. M. Annunziata Hospital, Health Unit 10 of Florence, I-50011 Antella, Florence, Italy
² Dermatopathology Centre, Di. S E M, University of Genoa, I-16132 Genoa, Italy
³ Institute of Dermatology, La Sapienza University, I-00161 Rome (Italy)
⁴ Molecular and Nutritional Epidemiology Unit, Cancer Research and Prevention Centre (CSPO), Scientific Institute of Tuscany, I-50100 Florence, Italy
⁵ Department of Human Pathology, University of Messina, I-98125 Messina, Italy
⁶ Institute of Dermatology, Tor Vergata University, I-00133 Rome, Italy
⁷ Institute of Dermatology, University of Bari, I-70100 Bari, Italy
⁸ Institute of Dermatology, University of Milan, I-20100 Milan, Italy
⁹ Institute of Dermatology, University of Turin, I-10126 Turin, Italy

Correspondence to:
Dr C Urso
Dermatopathology Section, S M Annunziata Hospital, I-50011 Antella, Florence, Italy; cylaur{at}tin.it Aims: To assess the interobserver reproducibility of certain histological features proposed for the diagnosis of melanoma.

Methods: In a series of melanomas, 13 histological parameters were analysed: dimension > 6 mm, asymmetry, poor circumscription, irregular confluent nests, single melanocytes predominating, absence of maturation, suprabasal melanocytes, asymmetrical melanin, melanin in deep cells, cytological atypia, mitoses, dermal lymphocytic infiltrate, and necrosis.

Results: The agreement (reproducibility) between the nine observers was excellent ( > 0.75) for 10 of the 13 examined features (dimension > 6 mm, poor circumscription, irregular confluent nests, single melanocytes predominating, absence of maturation, suprabasal melanocytes, asymmetrical melanin, melanin in deep cells, mitoses, and necrosis). The agreement for asymmetry was very close to excellence ( = 0.74), and that for cytological atypia ( = 0.65) and dermal lymphocytic infiltrate ( = 0.47) was slightly lower, but in the fair to good agreement range. The values obtained by comparison with the majority diagnosis were generally high ( 0.85); the mean value of was lower (0.70) for only one parameter (dermal lymphocytic infiltrate).

Conclusions: The parameters investigated showed an overall good reproducibility.

Keywords: melanoma; reproducibility; diagnosis; skin; histopathology

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