Detection of residual basal cell carcinoma by in vivo confocal microscopy
Detection of residual basal cell carcinoma by in vivo confocal microscopy
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DOI：
10.1097/00042728-200505000-00008
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发表时间：
2005-05-01
影响因子：
2.4
通讯作者：
Gonzalez, S
中科院分区：
文献类型：
--
作者：
Marra, DE;Torres, A;Gonzalez, S
背景近红外反射模式共聚焦扫描激光显微镜（RCM）代表了一种新的成像技术，用于皮肤病变的显微分析，并可能为基底细胞癌（BCC）的诊断提供一种非侵入性的方式。确定应用RCM检测残留或临床可疑BCC的可行性。在这项初步研究中，在3例病例中使用RCM来表征体内索引病变的组织学特征。这些随后与相应的苏木素染色切片在Mobs显微手术中获得。通过RCM对临床可疑病变的评价显示了BCC的特征，包括细长的、单形的、极化的细胞核的紧密堆积的巢和淋巴细胞经历边缘化和滚动的扩张血管。常规组织学检查证实所有病例均存在基底细胞癌。我们报告使用RCM在确认残留BCC在两个案件和初步诊断与随后的病理形态的第三个案件中，活检是以前不够的。我们的研究结果表明，共聚焦显微镜可以促进BCC在体内的诊断，并保证进一步的前瞻性研究，以量化这种快速发展的成像方式的灵敏度和特异性。
BACKGROUND. Near-infrared reflectance-mode confocal scanning laser microscopy (RCM) represents a novel imaging technique for microscopic analysis of skin lesions and may provide a non-invasive modality for the diagnosis of basal cell carcinoma (BCC).OBJECTIVE. To determine the feasibility of detecting residual or clinically equivocal BCC using RCM.METHODS. In this pilot study, RCM was used in three cases to characterize the histologic features of index lesions in vivo. These were subsequently correlated with corresponding hematoxylineosin-stained sections obtained during Mobs micrographic surgery.RESULTS. Evaluation of clinically equivocal lesions by RCM revealed features characteristic of BCC, including tightly packed nests of elongated, monomorphic, polarized nuclei and subjacent ectatic blood vessels with lymphocytes undergoing margination and rolling. Conventional histology confirmed the presence of BCC in all cases.CONCLUSION. We report the use of RCM in the confirmation of residual BCC in two cases and the tentative diagnosis with subsequent pathologic conformation of a third case in which a biopsy was previously inadequate. Our results demonstrate that confocal microscopy may facilitate diagnosis of BCC in vivo and warrant further prospective study to quantify the sensitivity and specificity of this rapidly evolving imaging modality.