Evaluating ex vivo fluorescence confocal microscopy images of basal cell carcinomas in Mohs excised tissue.
Title | Evaluating ex vivo fluorescence confocal microscopy images of basal cell carcinomas in Mohs excised tissue. |
Publication Type | Journal Article |
Year of Publication | 2014 |
Authors | Longo, C., Rajadhyaksha M., Ragazzi M., Nehal K., Gardini S., Moscarella E., Lallas A., Zalaudek I., Piana S., Argenziano G., & Pellacani G. |
Journal | Br J Dermatol |
Volume | 171 |
Issue | 3 |
Pagination | 561-70 |
Date Published | 2014 Sep |
ISSN | 1365-2133 |
Keywords | Adult, Aged, Carcinoma, Basal Cell, Female, Humans, Male, Microscopy, Confocal, Microscopy, Fluorescence, Middle Aged, Mohs Surgery, Skin Neoplasms, Young Adult |
Abstract | BACKGROUND: Fluorescence confocal microscopy (FCM) is an emerging technology for rapid imaging of excised tissue, without the need for frozen- or fixed-section processing. Basal cell carcinomas (BCCs) can be detected in Mohs excisions although few studies have described the major BCC findings as seen on FCM.OBJECTIVES: To describe the major BCC findings of excised tissue during Mohs surgery and to correlate them with histopathology.METHODS: Freshly excised tumours and frozen-thawed discarded tissue of BCC during Mohs surgery were analysed by means of FCM. A side-by-side correlation between FCM images and histological sections was performed. The FCM features of overlying skin and adnexal structures were also described.RESULTS: Sixty-four BCC cases were analysed. Distinct BCC types appeared unique in terms of shape and size of tumour islands [bigger in nodular (18/25), smaller and rounded in micronodular (7/7) and tiny cords for infiltrative ones (24/30)] and for the presence of clefting, palisading and increased nucleus/cytoplasm ratio. An excellent correlation was found between FCM and histological findings (Cohen's κ statistics = 0·9). In six cases, the presence of sebaceous glands and intense stroma reaction represented possible confounders.CONCLUSIONS: Fluorescence confocal microscopy is a fast and new imaging technique that allows an excellent visualization of skin structures and BCC findings during Mohs surgery. |
DOI | 10.1111/bjd.13070 |
Alternate Journal | Br J Dermatol |
PubMed ID | 24749970 |
Grant List | P30 CA008748 / CA / NCI NIH HHS / United States |