Real-time, in vivo confocal reflectance microscopy of basal cell carcinoma.

BACKGROUND Real-time, near-infrared confocal laser scanning microscopy may provide a way to diagnose basal cell carcinoma in vivo and might potentially eliminate the need for invasive diagnostic biopsies in the future. OBJECTIVE The purpose of this study is to define the in vivo histologic features of basal cell carcinoma by using a high-resolution imaging technique. METHODS Five fair-skinned white patients with 8 basal cell carcinoma lesions were recruited for this study. Near-infrared reflectance confocal microscopy imaging was used to characterize the histologic features of these lesions in vivo. Subsequently, the confocal histologic features were correlated with the corresponding routine hematoxylin-and-eosin-stained sections obtained from invasive biopsies. RESULTS A uniform population of basal cell carcinoma cells with characteristic elongated nuclei oriented along the same axis was always present. Abundant blood vessels demonstrating prominent tortuosity were seen, as well as prominent, predominantly mononuclear inflammatory infiltrate admixed or in close apposition with basal cell carcinoma cells. Trafficking of leukocytes was visualized in real time. CONCLUSION Our results demonstrate that near-infrared confocal microscopy may facilitate diagnosis of basal cell carcinoma with the use of in vivo high-resolution confocal features. Accuracy studies to evaluate these in vivo histologic criteria are warranted.

[1]  M. Rajadhyaksha,et al.  Confocal scanning laser microscopy of benign and malignant melanocytic skin lesions in vivo. , 2001, Journal of the American Academy of Dermatology.

[2]  M. Rajadhyaksha,et al.  Real-time evidence of in vivo leukocyte trafficking in human skin by reflectance confocal microscopy. , 2001, The Journal of investigative dermatology.

[3]  A. Halpern,et al.  Detection of clinically amelanotic malignant melanoma and assessment of its margins by in vivo confocal scanning laser microscopy. , 2001, Archives of dermatology.

[4]  M Rajadhyaksha,et al.  Topographic variations in normal skin, as viewed by in vivo reflectance confocal microscopy. , 2001, The Journal of investigative dermatology.

[5]  R. Anderson,et al.  Confocal laser microscopic imaging of actinic keratoses in vivo: a preliminary report. , 2000, Journal of the American Academy of Dermatology.

[6]  R. Anderson,et al.  Time-sequence histologic imaging of laser-treated cherry angiomas with in vivo confocal microscopy. , 2000, Journal of the American Academy of Dermatology.

[7]  R. Webb,et al.  In vivo confocal scanning laser microscopy of human skin II: advances in instrumentation and comparison with histology. , 1999, The Journal of investigative dermatology.

[8]  M Rajadhyaksha,et al.  Allergic contact dermatitis: correlation of in vivo confocal imaging to routine histology. , 1999, Journal of the American Academy of Dermatology.

[9]  M. Rajadhyaksha,et al.  Confocal imaging of sebaceous gland hyperplasia in vivo to assess efficacy and mechanism of pulsed dye laser treatment , 1999, Lasers in surgery and medicine.

[10]  M. Rajadhyaksha,et al.  Characterization of psoriasis in vivo by reflectance confocal microscopy. , 1999, Journal of medicine.

[11]  R. Webb Confocal optical microscopy , 1996 .

[12]  R. Webb,et al.  In vivo confocal scanning laser microscopy of human skin: melanin provides strong contrast. , 1995, The Journal of investigative dermatology.

[13]  J. Pawley,et al.  Handbook of Biological Confocal Microscopy , 1990, Springer US.