Reflectance confocal microscopy of pigmented basal cell carcinoma
Reflectance confocal microscopy of pigmented basal cell carcinoma
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DOI：
10.1016/j.jaad.2005.11.1096
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发表时间：
2006-04-01
影响因子：
13.8
通讯作者：
Halpern, AC
中科院分区：
文献类型：
--
作者：
Agero, ALC;Busam, KJ;Halpern, AC
背景：反射共聚焦显微镜（RCM）是一种高分辨率成像工具，用于体内无创评估皮肤病变。目的：我们试图描述色素性基底细胞癌（BCC）的相关RCM特征。方法：使用皮肤镜和RCM对色素性皮肤病变进行成像，以鉴别诊断色素性BCC，然后切除色素性基底细胞癌。 组织学分析。结果：RCM显示细胞紧密排列，呈栅栏状聚集，形成边界不规则、亮度不一的索状结构和结节；这些在组织病理学上代表色素沉着的基底样肿瘤细胞巢，在皮肤镜检查上代表蓝灰色卵圆形区域。这些肿瘤巢与明亮的树突状结构相关，在组织学上被鉴定为黑素细胞或朗格汉斯细胞，以及许多明亮的椭圆形至星状结构，其边界不明显，代表黑素细胞，并具有高度折射的黑色素颗粒。检测浸润性和异型性 BCC 可能需要一套不同的或额外的标准。结论：RCM 可能允许色素性 BCC 的体内诊断。
Background: Reflectance confocal microscopy (RCM) is a high-resolution imaging tool for in vivo noninvasive evaluation of skin lesions.Objective: We Sought to describe the relevant RCM features for pigmented basal cell carcinoma (BCC).Methods: Pigmented skin lesions with a differential diagnosis of pigmented BCC were imaged using dermoscopy and RCM, followed by excision for histologic analysis.Results: RCM demonstrated aggregations of tightly packed cells with palisading, forming cordlike structures and nodules with irregular borders and variable brightness; these represented nests of pigmented basaloid tumor cells on histopathology, and blue-gray ovoid areas on dermoscopy. These tumor nests were associated with bright dendritic structures, identified histologically as either melanocytes or Langerhans cells, together with numerous bright oval to stellate-shaped structures with indistinct borders representing melanophages, and with highly refractile granules of melanin.Limitations: The pigmented BCCs imaged in this study were predominantly nodular; a different set or additional criteria may be necessary for detection of infiltrative and metatypical BCCs.Conclusion: RCM may permit in vivo diagnosis of pigmented BCC.