Microscopic in vivo description of cellular architecture of dermoscopic pigment network in Nevi and melanomas
Microscopic in vivo description of cellular architecture of dermoscopic pigment network in Nevi and melanomas
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DOI：
10.1001/archderm.141.2.147
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发表时间：
2005-02-01
影响因子：
--
通讯作者：
Seidenari, S
中科院分区：
文献类型：
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作者：
Pellacani, G;Cesinaro, AM;Seidenari, S
目的：利用激光共聚焦扫描显微镜观察活体皮肤镜下色素网络的微观形态。设计：对皮肤镜下以色素网络为特征的黑素细胞病变进行共聚焦成像。组织：大学医学系。研究人群：我们研究了15例黑色素瘤、15例皮肤镜下不典型痣和15例常见痣的共聚焦图像。主要观察指标：指真皮乳头的外观、大小、规律性、均质性和浸润性以及细胞大小、规律性和非典型性的特征由2名观察者在共聚焦图像上描述。结果：黑色素瘤的色素网络由较大的基底细胞组成，包围着中小型真皮乳头，细胞异型性明显，有时可见真皮乳头的浸润性。另一方面，常见的获得性痣以缺乏非典型细胞和边缘真皮乳头为特征。结论：细胞异型性是诊断黑色素瘤最敏感的特征，而真皮乳头内有核细胞的存在是最具特异性的。
Objective: To characterize the microscopic aspects of the dermoscopic pigment network in vivo, by means of confocal scanning laser microscopy.Design: Confocal imaging was performed on melanocytic lesions characterized by pigment network at dermoscopy. Some confocal architectural and cytologic features, as observed at the dermoepidermal junction, were morphologically described and quantified by means of a dedicated program.Setting: University medical department.Study Population: We studied confocal images of 15 melanomas, 15 dermoscopic atypical nevi, and 15 common nevi.Main Outcome Measures: Features referring to aspect, size, regularity, homogeneity, and infiltration of dermal papillae and to cellular size, regularity, and atypia were described by 2 observers on confocal images. Mean dermal papillary diameter, mean cell area, and shape irregularity were quantified by drawing papillae and cell contours on confocal images and measured with the use of a computer program.Results: Pigment network in melanomas consisted of large basal cells that circumscribed small to medium-sized dermal papillae with marked cellular atypia, sometimes infiltrating dermal papillae. On the other hand, common acquired nevi were characterized by lack of atypical cells and edged dermal papillae. Atypical nevi presented intermediate characteristics between clearly benign and malignant lesions.Conclusion: Cellular atypia was the most sensitive feature for melanoma diagnosis, whereas the presence of nucleated cells infiltrating dermal papillae was the most specific one.