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Table 4 Summary of the challenging tumours

From: A p16-Ki-67-HMB45 immunohistochemistry scoring system as an ancillary diagnostic tool in the diagnosis of melanoma

Case & Initial diagnosis Malignancy criteria p16 (% & score) Ki-67 (% & score) HMB45 gradient (& score) p16-Ki-67 score p16-Ki67-HMB45 score
Case #1: Cellular blue nevus, leg, 14 year-old boy FISH : chromosome 6 polysomy, 8p34 gain, 9p21 double deletion, 11q13.1 gain 15 % (score 1) 3 % (score 1) Absent (score 2) Score 2 Score 4
Case #2: Spitz nevus, back, 42 year-old woman FISH: chromosomes 6 and 8 polysomies, 9p21 double deletion, 11q13.1 gain 0 % (score 3) 12 % (score 3) Absent (score 2) Score 6 Score 8
Case #3: SSM on preexisting nevus, back, 59 year-old man Clear SSM features Whole lesion : 70 % (score 0) Atypical component : 0 % (score 3) 10 % (score 2) Doubtful (score 1) Whole lesion: score 3 SSM: score 6 Whole lesion: score 2 SSM: score 5
Case #4: SSM on preexisting nevus, ear, 64 year-old man Clear SSM features Whole lesion : 70 % (score 0) Atypical component : 0 % (score 3) 10 % (score 2) Doubtful (score 1) Whole lesion: score 3 SSM: score 6 Whole lesion: score 2 SSM: score 5
Case #5: Nevus, back, 41 year-old man Metastatic evolution : reclassed as SSM 80 % (score 0) 20 % (score 3) Absent (score 2) Score 3 Score 5
Case #6: Nevus, back, 39 year-old woman Metastatic evolution : reclassed as nevoid melanoma 5 % (score 2) 8 % (score 2) Inconclusive (score 1) Score 4 Score 5
Case #7: Atypical nevus, knee, 43 year-old man Metastatic evolution : reclassed as nodular melanoma 0 % (score 3) 16 % (score 3) Present (score 0) Score 6 Score 6
Case #8: Spitz nevus, thigh, 24 year-old man Metastatic evolution : reclassed as Spitzoid melanoma 0 % (score 3) 12 % (score 3) Absent (score 2) Score 6 Score 8
Case #9: Nevoid melanoma, 17-year old girl, calf Concomitant metastasis 20 % (score 1) 12 % (score 3) Absent (score 2) Score 4 Score 6
aCase #10: Spitzoid tumour, knee, 17-year old girl, knee Review by an international expert in melanocytic pathology, reclassed as Spitzoid melanoma 15 % (score 1) 25 % (score 4) Inconclusive (score 1) Score 5 Score 6
aCase #11: SSM, back, 58-year old woman No final histological criteria of malignancy, reclassed as a compound nevus 60 % (score 0) 1 % (score 0) Inconclusive (score 1) Score 0 Score 1
  1. SSM superficial spreading melanoma
  2. acases from the validation set