Confocal microscopy features of patch‐stage mycosis fungoides and their correlation with horizontal histopathological sections. A case series

Reflectance confocal microscopy of solitary mastocytoma and correlation with horizontal histopathological sections

“…This typical mast cell infiltrate is one of the four mastocytosis diagnostic patterns described above. Of note, HHS, which shares with RCM the en face view of the skin, confirms to strongly correlate with RCM findings, as already described in other inflammatory and neoplastic skin disorders 7‐9 …”

Systematic review and proposal of an in vivo reflectance confocal microscopy assessment tool for cutaneous lymphoma

“…The difference between horizontal and vertical perspectives is also a limitation for the histopathological correlation. In the literature, horizontal cuts in histopathology reportedly can facilitate the correlation with RCM . However, in daily practice, the pathologists verified that it is not possible to guarantee that all layers will be visualized with the horizontal cut.…”

Correlation Between In Vivo Reflectance Confocal Microscopy and Horizontal Histopathology in Skin Cancer: A Review

“…Both clinical presentation and histopathology of MF are often non-specific, especially when it occurs in the form of patchy lesions, to such an extent that multiple biopsies are often necessary to obtain a definitive diagnosis ( 19 , 21 ). RCM may improve the diagnostic accuracy of MF ( 13 , 22 , 23 ). In the upper portion of epidermis, epidermal disarray with disruption of the normal “honeycomb” appearance and sometimes hyporefractive areas, combined to the detection of small sized bright cells interspersed within epidermal layers are usually identifiable with RCM ( 13 ) ( Figure 2A ); the same bright cells are found at the dermoepidermal junction both inside and around dermal papillae, visible as round darker areas ( 13 ).…”

“…RCM may improve the diagnostic accuracy of MF ( 13 , 22 , 23 ). In the upper portion of epidermis, epidermal disarray with disruption of the normal “honeycomb” appearance and sometimes hyporefractive areas, combined to the detection of small sized bright cells interspersed within epidermal layers are usually identifiable with RCM ( 13 ) ( Figure 2A ); the same bright cells are found at the dermoepidermal junction both inside and around dermal papillae, visible as round darker areas ( 13 ). RCM features of MF perfectly match with HHS ( 13 ): the presence of spongiosis, epidermotropic CD4-positive lymphocytes ( Figures 2B, C ) forming Pautrier’s microabscesses and band-like distributed CD4-positive lymphocytes at dermoepidermal junction are the histopathological “mirror” of what is detectable with RCM.…”

“…In the upper portion of epidermis, epidermal disarray with disruption of the normal “honeycomb” appearance and sometimes hyporefractive areas, combined to the detection of small sized bright cells interspersed within epidermal layers are usually identifiable with RCM ( 13 ) ( Figure 2A ); the same bright cells are found at the dermoepidermal junction both inside and around dermal papillae, visible as round darker areas ( 13 ). RCM features of MF perfectly match with HHS ( 13 ): the presence of spongiosis, epidermotropic CD4-positive lymphocytes ( Figures 2B, C ) forming Pautrier’s microabscesses and band-like distributed CD4-positive lymphocytes at dermoepidermal junction are the histopathological “mirror” of what is detectable with RCM. In addition, the differential diagnosis with eczematous disorders can become more straightforward using RCM ( 13 ), that shows in the stratum spinosum widespread round, deeply dark areas, intercellular spaces and few mildly bright cells: these findings are confirmed by horizontal histopathology, displaying marked spongiotic features combined to a less conspicuous lymphocytic exocytosis than MF ( 13 ).…”