Semiology and Pattern Analysis in Nonmelanocytic Lesions

Malvehy, Josep; Hanke-Martinez, Myrna; Costa, J. R. da; Salerni, Gabriel; Carrera, Cristina; Puig, Susana

doi:10.1007/978-3-642-21997-9_18

Cited by 11 publications

(11 citation statements)

References 19 publications

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“…Atypical honeycomb pattern formed by bright cellular outlines varying in size, shape and in the thickness and brightness of the lines assessed at the level of the stratum spinosum…”

Section: Methodsmentioning

confidence: 99%

Histopathology and reflectance confocal microscopy features of photodamaged skin and actinic keratosis

Tan

Lambie

Sinnya

et al. 2016

Acad Dermatol Venereol

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The viable epidermis demonstrates PD and AK to be part of a disease continuum corresponding to field cancerization. Individual corneocytes, stratum corneum disruption, dermal inflammatory cells, increased vascularity/dilated vessels and solar elastosis may be present in PD; whereas, parakeratosis and hyperkeratosis may represent the key to distinguishing AK from PD using RCM. The significance of epidermal inflammatory cells in the RCM diagnosis of AK remains to be elucidated.

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“…Atypical honeycomb pattern formed by bright cellular outlines varying in size, shape and in the thickness and brightness of the lines assessed at the level of the stratum spinosum…”

Section: Methodsmentioning

confidence: 99%

Histopathology and reflectance confocal microscopy features of photodamaged skin and actinic keratosis

Tan

Lambie

Sinnya

et al. 2016

Acad Dermatol Venereol

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“…Thirty‐six RCM criteria according to distinct diagnosis are reported in Table along with the references where they were first described . RCM criteria for melanoma metastasis (in transit) have not been described and we used the same diagnostic criteria as for melanoma.…”

Section: Methodsmentioning

confidence: 99%

Is confocal microscopy a valuable tool in diagnosing nodular lesions? A study of 140 cases

et al. 2013

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SummaryBackground Nodular lesions pose diagnostic challenges because nodular melanoma may simulate all kinds of melanocytic and nonmelanocytic lesions. Reflectance confocal microscopy (RCM) is a novel technique that allows visualization of the skin at nearly histological resolution although limited laser depth penetration hampers visualization of the deep dermis. Objectives We sought to assess whether the diagnostic accuracy of RCM was comparable to histopathology for the diagnosis of nodular lesions, and to identify possible limitations of this technique. Methods We retrospectively evaluated 140 nodules by means of RCM while blinded from the histopathological diagnosis. At the end of the study the patient codes were broken and the evaluations were matched with histopathological diagnosis before performing statistical analysis. Results The study consisted of 140 nodular lesions (23 'pure' nodular melanomas, nine melanoma metastases, 28 BCCs, six invasive SCCs, 32 naevi, 14 seborrhoeic keratoses, 17 dermatofibromas, five vascular lesions and six other lesions). RCM correctly diagnosed 121 of 140 lesions (86Á4%); eight of 140 (5Á7%) lesions revealed discordance between histopathology and confocal microscopy. Eight of the 140 (5Á7%) cases were not evaluable by means of RCM due to the presence of ulceration or hyperkeratosis and three cases showed a nonspecific pattern. Interestingly, confocal microscopy reached a 96Á5% sensitivity and 94Á1% specificity (area under curve 0Á970) (95% CI 0Á924-1Á015) (P < 0Á001) for the diagnosis of melanoma. Conclusions The study is retrospective and lesions were not included on the basis of their diagnostic difficulty. Despite the limited laser depth penetration of RCM, this imaging tool represents an effective instrument in diagnosing nodular lesions; however, for fully ulcerated lesions or when a marked hyperkeratosis is present, biopsy should always be performed. Prospective studies on difficult-todiagnose nodules should be performed to analyse further the pros and cons of RCM in skin cancer diagnosis.

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“…The key RCM features of sebaceous hyperplasia include enlarged sebaceous lobules with a dilated central follicular infundibulum containing keratin and sebum . The sebaceous lobules are composed of round cells with bright speckled cytoplasm and centrally located round nuclei . The superficial dermis lacks the fibroplasia that is often seen in a basal cell carcinoma.…”

Section: Reflectance Confocal Microscopy Of Benign Neoplasmsmentioning

confidence: 99%

In vivo reflectance confocal microscopy image interpretation for the dermatopathologist

et al. 2018

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Reflectance confocal microscopy (RCM) is a technology utilized for bedside diagnosis of cutaneous pathology by non-invasive, in vivo, cellular-level imaging. With the recent establishment of reimbursement codes by the US Centers for Medicaid and Medicare Services, RCM is now likely to be employed by clinical dermatologists and impact decision making on skin cancer management. Dermatopathologists, therefore, would benefit from learning how to interpret RCM images and how RCM findings correlate with histopathological criteria of diagnosis. This review briefly explains the principles behind RCM image acquisition, describes the key RCM features of normal skin, and delineates the RCM characteristics of frequently observed benign and malignant neoplasms.benign neoplasms, confocal microscopy, melanoma, nonmelanoma skin cancers | INTRODUCTIONThe most definitive diagnostic tool utilized by dermatologists in the assessment of skin lesions is a biopsy for histopathological microscopic analysis. However, the invasive nature of surgical biopsy engenders anxiety for some patients, can leave scars in cosmetically sensitive areas (e.g., the face and chest), and may have procedureassociated morbidity such as infection and delayed healing (e.g., on the lower extremities). To this end, reflectance confocal microscopy (RCM) offers non-invasive imaging of skin lesions at cellular-level magnification and resolution, and may facilitate curbing unnecessary Herein, we provide a succinct review of the principles of RCM imaging, describe key RCM terminology and delineate the fundamental RCM features of normal skin and neoplastic entities. | BASIC PRINCIPLESRCM utilizes a low-energy laser light source that focuses on a specific area of tissue. Light is back-scattered from certain tissue structures at the focal point, and enters the detector through a small-aperture gating pinhole; only light from the focal point at the tissue will enter and produce an image, while light from nearby tissue ("out of focus") will not be able to enter the detector.

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Semiology and Pattern Analysis in Nonmelanocytic Lesions

Cited by 11 publications

References 19 publications

Histopathology and reflectance confocal microscopy features of photodamaged skin and actinic keratosis

Histopathology and reflectance confocal microscopy features of photodamaged skin and actinic keratosis

Is confocal microscopy a valuable tool in diagnosing nodular lesions? A study of 140 cases

In vivo reflectance confocal microscopy image interpretation for the dermatopathologist

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