反射式共聚焦显微镜所示黑素瘤和痣中Paget样黑素细胞增生的体内特征  

Reflectance-mode confocal microscopy for the in Vivo characterization of pagetoid melanocytosis in melanomas and nevi

作　　者：Pellacani G Cesinaro A.M Seidenari S. 罗素菊 

机构地区：[1]Department Department of Dermatology,University of Modena and Reggio Emilia, Via del Pozzo 71, 41100 Modena, Italy

出　　处：《世界核心医学期刊文摘（皮肤病学分册）》2006年第9期11-11,共1页Digest of the World Core Medical JOurnals:Dermatology

摘　　要：Pagetoid infiltration of the epidermis by melanocytes is a relevant criterion for the histologic diagnosis of melanoma, although sporadically observable in benign lesions. Since in vivo reflectance-mode confocal microscopy enables the visualization of superficial layers at cellular-level resolution, the different aspects and the diagnostic significance of epidermal alterations and pagetoid cell infiltration were investigated on 84 benign and malignant melanocytic lesions by confocal microscopy and compared with histopathology. The observation of a disarranged pattern in superficial layers appeared characteristic for malignant lesions. In vivo identification of pagetoid cells, clearly present in the majority of melanomas and in a few benign lesions, seemed useful for melanoma diagnosis. An excellent concordance between confocal microscopy and histopathologywas achieved. Moreover, identification of some characteristic features by confocal microscopy, such as large and numerous closely arranged cells extended to the stratum corneum, was strongly correlated with malignancy. In conclusion, confocal microscopy enabled a very good identification of melanocytes spreading upward in a pagetoid fashion in melanocytic lesions. Thus, when pagetoid melanocytosis is observable by means of confocal microscopy, melanoma diagnosis should be considered, whereas it cannot be excluded in the absence of pagetoid cells, lacking in at least 10% of malignant lesions.Pagetoid infiltration of the epidermis by melanocytes is a relevant criterion for the histologic diagnosis of melanoma, although sporadically observable in benign lesions. Since in vivo reflectance-mode confocal microscopy enables the visualization of superficial layers at cellular-level resolution, the different aspects and the diagnostic significance of epidermal alterations and pagetoid cell infiltration were investigated on 84 benign and malignant melanocytic lesions by confocal microscopy and compared with histopathology. The observation of a disarranged pattern in superficial layers appeared characteristic for malignant lesions. In vivo identification of pagetoid cells, clearly present in the majority of melanomas and in a few benign lesions, seemed useful for melanoma diagnosis. An excellent concordance between confocal microscopy and histopathologywas achieved. Moreover, identification of some characteristic features by confocal microscopy, such as large and numerous closely arranged cells extended to the stratum corneum, was strongly correlated with malignancy. In conclusion, confocal microscopy enabled a very good identification of melanocytes spreading upward in a pagetoid fashion in melanocytic lesions. Thus, when pagetoid melanocytosis is observable by means of confocal microscopy, melanoma diagnosis should be considered, whereas it cannot be excluded in the absence of pagetoid cells, lacking in at least 10% of malignant lesions.

关 键 词：黑素细胞增生 PAGET样 共聚焦显微镜 体内特征 黑素瘤 反射式 诊断意义 组织病理学 

分 类 号：R739.5[医药卫生—肿瘤]