Diagnosis Of Skin Tumors Research Articles

Texture in skin images: Comparison of three methods to determine smoothness

Smooth texture, a critical feature in skin tumor diagnosis, is analyzed using three texture measurement methods. A dermatologist classified 1290 small blocks within 42 tumor images as smooth, partially smooth, or nonsmooth. Texture discriminatory power of three methods were compared: the neighboring gray-level dependence matrix (NGLDM) method of Sun and Wee, the circular symmetric autoregressive random field model of Kashyap and Khotanzad, and a new peak-variance method. The texture analysis method that allows best prediction of smoothness for our tumor domain is the NGLDM method, affording 98% correct prediction of a smooth block with 21% false positives. We discuss applicability of texture analysis to dermatology.

Applying artificial intelligence to the identification of variegated coloring in skin tumors

The importance of color information for the automatic diagnosis of skin tumors by computer vision is demonstrated. The utility of the relative color concept is proved by the results in identifying variegated coloring. A feature file paradigm is shown to provide an effective methodology for the independent development of software modules for expert system/computer vision research. An automatic induction tool is used effectively to generate rules for identifying variegated coloring. Variegated coloring can be identified at rates as high as 92% when using the automatic induction technique in conjunction with the color segmentation method.

Cutaneous cryptococcosis as the first symptom of a disseminated cryptococcosis in a patient with lymphogranulomatosis X

A 63-year-old patient, known to have suffered from lymphogranulomatosis X for 4 years is reported, in whom a cutaneous cryptococcosis appeared as first sign of a disseminated cryptococcosis. Despite systemic therapy with amphotericin B, the patient died after a period of 2 months. Differential diagnosis of skin tumours of immunosuppressed patients includes rare skin mycoses, and both histological and mycological examinations should be performed.

What's new in the skin?: Impact of recent techniques on the microscopic diagnosis and histogenesis of skin tumours

What's new in the skin?: Impact of recent techniques on the microscopic diagnosis and histogenesis of skin tumours

Morphometric Diagnosis of Melanocytic Skin Tumors

Checking consecutively sampled routine sections of 206 melanocytic lesions with a maximum vertical diameter of at least 1 mm (133 benign dermal nevi, 20 Spitz's nevi, 53 primary malignant melanomas), we measured the morphometric features of at least 60 nuclei each from the superficial and the deep dermal tumor portion using a computer-assisted interactive image analysis system. Furthermore we calculated the so-called maturation parameter (MP) in each case as the ratio of the mean nuclear area in the deep portion and the superficial portion. When we compared the results with those obtained in a training set, we found that the lowest evidence for the discrimination of benign and malignant melanocytic lesions resulted from the application of the mean values of the nuclear area in the superficial layer (efficiency = 62.1%). The efficiency was higher when we used the mean values of the nuclear area in the deep layer (96.1%) and the maturation parameter (85.4%). By applying the mean nuclear area in the deep portion and the maturation parameter simultaneously, we gained the highest efficiency, specificity, and sensitivity for the distinction between benign dermal nevi and malignant melanomas (0.968, 0.955, 1) as well as for the distinction between Spitz's nevi and malignant melanomas (0.986, 0.950, 1). Our study shows that morphometry provides reliable diagnostic results in routinely sampled melanocytic skin tumors.

Application of Immunohistochemistry in the Differential Diagnosis of Skin Tumors

As with neoplasms in any tissue, skin tumors may be categorized as epithelial or mesenchymal, benign or malignant, and primary or metastatic. Immunoperoxidase stains are useful in elucidating the nature of the tumor cells, especially in poorly differentiated tumors. It is important to consider that tumors may exhibit staining patterns different from the typical or reported results. This may be because of intrinsic features of the neoplasm such as the aberrant expression of antigens (markers). Furthermore, the staining of the tumor may be affected by tissue preservation and fixation as well as by the selection of antibodies used for staining. For this reason, the pathologist should be vigilant in comparing the results of unknown tumors with standard controls, with results in the literature, and with his or her own experience. Unusual neoplasms may require additional tissue for analysis, study by other ancillary methods such as electron microscopy, or consultation by more experienced laboratories. These guidelines should be helpful in providing accurate diagnosis of skin tumors.

Immunocytochemical diagnosis of skin tumours of the dog with special reference to undifferentiated types

Immunoperoxidase techniques for S-100 protein, keratin, cytokeratin, vimentin and desmin were applied to 65 canine skin tumours. These included eight squamous cell carcinomas, eight fibrosarcomas, eight melanomas, eight mastocytomas, eight haemangiosarcomas, eight leiomyosarcomas, five liposarcomas and 12 poorly differentiated tumours. Consistent results were obtained within each group. Cytokeratin and keratin immunoreactivity was detected only in squamous cell carcinomas. Vimentin was present in fibrosarcomas, melanomas, haemangiosarcomas, mastocytomas, leiomyosarcomas and liposarcomas. S-100 protein immunoreactivity was detected in melanomas, haemangiosarcomas, liposarcomas and leiomyosarcomas. Only leiomyosarcomas were positive for desmin. According to these results the 12 anaplastic tumours were diagnosed either as carcinomas, fibrosarcomas or malignant melanomas.

Skin cancer recognition by computer vision

Automatic detection of several features characteristic of basal cell epitheliomas is described. The features selected for this feasibility study are semitranslucency, telangiectasia, ulcer, crust, and tumor border. Image processing methods used in this study include frequency analysis of the Fourier transform of the image, the Sun-Wee texture analysis algorithm, and several other image analysis techniques suitable for skin photographs. This image analysis software is designed for use with AI/DERM, an expert system that models diagnosis of skin tumors by dermatologists.

Intermediate Filament Staining in the Cytologic and Histologic Diagnosis of Canine Skin and Soft Tissue Tumors

Formalin-fixed histologic and acetone-fixed cytologic preparations from 87 surgically removed subcutaneous and soft tissue canine tumors were examined for immunoreactivity to cytokeratin, desmin, and vimentin. The avidin-biotin complex (ABC) technique demonstrated immunoreactivity in both preparations, but the intensity and specificity of the reactions were dependent on the primary antibody. Polyclonal antibodies to cytokeratin were more consistent in immunoreactivity than were polyclonal desmin or vimentin antibodies. The monoclonal antibody proved more satisfactory for demonstrating vimentin than the polyclonal antibody. Greater dilutions of primary antibodies may be used on cytologic preparations than on histologic sections. Evaluation of cytologic preparations may be inconclusive due to background staining, scant cellularity, or poor cytoplasmic preservation.

Nuclear Parameters in the Superficial and Deep Portion of Melanocytic Lesions: A Morphometrical Investigation

Morphometric techniques in diagnostic pathology of pigmented skin lesions are not yet well established. The so-called maturation of melanocytes (nevus cells) with progressive descent into the dermis is one important criterion to differentiate benign from malignant melanocytic lesions in conventional histology. We therefore examined morphometrically the nuclear parameters of melanocytes (nevus cells) in the superficial and deep portion of 120 pigmented skin tumors (40 cases each of malignant melanoma. Spitz's nevus and benign dermal nevus) with special emphasis on the "maturation to the depth". A "maturation parameter" (MP) was assessed in each individual case, calculating the ratio of the nuclear area in the deep portion and in the superficial portion. The mean values of MP were 0.720 +/- 0.11 for dermal nevi, 0.725 +/- 0.10 for Spitz's nevi and 1.125 +/- 0.11 for malignant melanoma. The difference between malignant melanoma and both groups of benign nevi was statistically significant (p less than or equal to 0.01). The efficiency of the maturation parameter was 0.95 for the distinction of dermal nevi and malignant melanomas, and 0.97 for the distinction of Spitz's nevi and malignant melanoma. Measurements of the superficial portion only revealed comparatively low efficiency values (0.70 and 0.56, respectively). Our results indicate that morphometric evaluations of the nuclear area of melanocytes (nevus cells) in the deep portion of the infiltrate are more discriminative than those in the superficial portions. The establishment of the MP allows a better differentiation between benign and malignant melanocytic lesions and therefore morphometric methods may obviously be a helpful tool in the diagnosis of melanocytic skin tumors.

Distribution of melanoma specific antibody (HMB-45) in benign and malignant melanocytic tumours. An immunohistochemical study on paraffin sections.

The distribution of a recently produced melanoma specific antibody (HMB-45) has been evaluated histochemically on paraffin sections in a large panel of melanocytic and non melanocytic tumours. Results have been compared with the presence of S-100 protein. HMB-45 was shown to be a highly specific antibody being present only in melanomas, junctional melanocytes and histogenetically related neoplasms such as melanocytic neuroectodermal tumour of infancy and, at low levels, on a proportion of peripheral nerve sheath tumours. The high specificity of HMB-45 antibody, coupled with the greater sensitivity of S-100, makes the combined use of these markers practical in the differential diagnosis of skin tumours and of metastatic lesions of uncertain primary site.

Diagnostic immunohistochemistry of canine round cell tumors.

Sixty-five canine skin neoplasms studied using immunocytochemistry, included 22 histiocytomas, 18 amelanotic melanomas, 14 cutaneous lymphosarcomas, six mast cell tumors, and five transmissible venereal tumors. Formalin-fixed, paraffin-embedded sections were stained using the avidin-biotin-peroxidase complex (ABC) immunoperoxidase technique for reactivity with S-100 protein, kappa and lambda immunoglobulin light chains, alpha-1-antitrypsin, alpha-1-antichymotrypsin, leukocyte common antigen (LCA), neuron-specific enolase, keratin, cytokeratin, muramidase, and vimentin. Detection of S-100, kappa and lambda light chains, neuron-specific enolase, and vimentin were most useful for screening these neoplasms. None of the markers examined was consistent in staining histiocytomas. While reactivity of S-100 (ten cases) and neuron-specific enolase (ten cases) was detected in some amelanotic melanomas, lambda light chain immunoglobulin (eight cases) was relatively consistent in cutaneous lymphomas. Mast cell neoplasms reacted with avidin and, therefore, were positive, even on negative control sections. Vimentin reacted strongly on all amelanotic melanomas and transmissible venereal tumors examined. These antibodies are helpful adjuncts in the differential diagnosis of canine skin tumors.

Antigenic Differences and Further Perspectives on the Differential Diagnosis of Skin Tumors

AbstractFrozen sections from squamous cell carcinomas (SCCs), basal cell carcinomas (BCCs), precancerous lesions (P.C.) and normal skin adjacent to lesions (N.S.) were studied by indirect immunoperoxidase for the detection of epithelial membrane antigen (EMA) and by PAP (peroxidase‐antiperoxidase) for total keratin (T.K.) and laminin (LM) to determine the significance of the appearance of neoantigens and the behavior of normal epidermal antigens during the process of carcinogenesis of the skin. Significant antigenic differences in all three antigens were revealed between SCCs and BCCs in the epidermis (EP) and tumor islands (T.I.). There were also significant differences in total keratin and laminin between SCC's and N.S. epidermis. SCCs did not show any significant differences in EMA from P.C. lesions, but T.K. was lower in P.C. lesions than in normal skin.

Clinical diagnosis of skin tumors by dermatologists.

Apparently trained practicing dermatologists can accurately diagnose a wide variety of skin tumors. A representative group was found to be correct in 85% of the cases when first and second choices as to clinical diagnosis are considered. When only first choice is evaluated the percentage accuracy is only 5% less at 80%. While a high degree of clinical accuracy was established, this finding should not exclude judicious use of pathologic study. By combining a clinician's impression with a pathologist's interpretation the over-all final diagnostic accuracy can rise to a level approaching 100%.

Radioactive Phosphorus in the Diagnosis of Skin Tumors

Radioactive Phosphorus in the Diagnosis of Skin Tumors