Hyporeflective pagetoid cells: a new clue for amelanotic melanoma diagnosis by reflectance confocal microscopy

Losi, A.; Longo, Caterina; Cesinaro, Anna Maria; Benati, Elisa; Witkowski, Alexander; Guitera, Pascale; Pellacani, Giovanni

doi:10.1111/bjd.12781

Cited by 54 publications

(46 citation statements)

References 37 publications

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“…On confocal microscopy there are few studies that reported characteristics of this type of melanoma [16,17,18,19,20]. Recently, hyporeflective pagetoid cells have been claimed as a new clue in the diagnosis of amelanotic melanoma [21]. In the same paper, the authors suggest that a solitary hypopigmented lesion, in the absence of any specific nonmelanocytic or melanocytic features, should always be excised due to the probability of melanoma diagnosis.…”

Section: Discussionmentioning

confidence: 99%

False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal

et al. 2016

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Background: Confocal microscopy is a second-level examination for dermoscopically equivocal melanocytic lesions. However, the number of false-negative cases on confocal microscopy and the scenarios in which confocal microscopy may fail have not been fully elucidated. Objective: To calculate the percentage of false-negative melanomas upon reflectance confocal microscopy examination in a large series of cases. Methods: A retrospective analysis on 201 melanomas, evaluated for dermoscopic/confocal criteria of melanoma, was carried out. Results: Twenty-three melanomas out of 201 cases (11.4%) revealed a low 7-point checklist score. On confocal examination, 22 out of 23 lesions have been diagnosed correctly as melanomas. Only 1 lesion did not display melanoma features, neither upon dermoscopy nor upon confocal microscopy examination. Seven lesions out of 201 cases (3.5%) were judged as negative on confocal examination, even if 6 of them were diagnosed as melanomas by clinical and/or dermoscopic evaluation. After histopathological revision, these cases were grouped into 5 categories: (1) amelanotic melanoma (n = 1), (2) hyperkeratotic melanomas (n = 2), (3) lentiginous melanomas (n = 2), (4) melanoma with small pagetoid cells (n = 1), (5) spitzoid melanoma (n = 1). Conclusion: Confocal and dermoscopic examination, along with patient-related information and clinical history, can lead to an optimal patient management.

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Section: Discussionmentioning

confidence: 99%

False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal

et al. 2016

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“…It has been shown that RCM improves the ability to correctly identify both nevi and early melanomas in red-haired and fair skin–type patients, such as those with albinism. 32–34 …”

Section: Role Of Reflectance Confocal Microscopy In Detecting Melanommentioning

confidence: 99%

Discriminating Nevi from Melanomas

Carrera

Marghoob

2016

Dermatologic Clinics

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“…In such lesions, melanocytes and pigmented keratinocytes appear very bright compared with background tissue, rendering a distinctive contrast to architectural and cellular details. Most recently, some publications reported RCM features observed in pink, hypopigmented, or amelanotic lesions; in those entities, the reflectance is provided by melanosomes and intracellular organelles of approximately 500 nm in diameter, especially in the background of a completely amelanotic tissue surrounding the tumor [6][7][8][9][10][11] .…”

Section: Discussionmentioning

confidence: 99%

Similar but Different: How Reflectance Confocal Microscopy May Help in the Diagnosis of Pink Lesions

Ferrari

Bassoli²,

Pellacani³

et al. 2017

Dermatology

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Background: Among skin neoplasms, solitary pink tumors represent challenging lesions in clinical practice since they can mimic melanocytic and nonmelanocytic lesions or even inflammatory ones. Objective: In this case series we described dermoscopic and confocal features of 2 couples of similar lesions in order to achieve the correct diagnosis and the best therapeutic approach. Methods: During clinical routine practice, 2 couples of clinically and dermoscopically similar lesions were examined by means of confocal microscopy. Results: All lesions revealed no clear-cut diagnostic features on dermoscopy. However, confocal microscopy revealed tumor islands with palisading cells and a dark clefting at the periphery in basal cell carcinomas. In the other “false twin” lesions, atypical cells and elongated junctional nests were observed and the diagnosis of amelanotic melanomas was rendered. Conclusions: In the current case series, the combined use of dermoscopy and reflectance confocal microscopy was an optimal workup for difficult-to-diagnose lesions such as pink tumors.

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Hyporeflective pagetoid cells: a new clue for amelanotic melanoma diagnosis by reflectance confocal microscopy

Cited by 54 publications

References 37 publications

False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal

False-Negative Cases on Confocal Microscopy Examination: A Retrospective Evaluation and Critical Reappraisal

Discriminating Nevi from Melanomas

Similar but Different: How Reflectance Confocal Microscopy May Help in the Diagnosis of Pink Lesions

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