Preliminary Evaluation of in vivo Reflectance Confocal Microscopy Features of Kaposi’s Sarcoma

Abstract

Background: Kaposi’s sarcoma (KS) is an unusual, clinically polymorphic, vascular neoplasm with genetic, infectious, environmental and immunological pathogenesis. Reflectance confocal microscopy (RCM) made in vivo noninvasive imaging of the skin possible and has been used for the evaluation of several skin diseases offering important microscopic information. Objective: The purpose of our study is to describe the RCM features of KS and correlate them with histopathology evaluating the effective prediction attitude and repeatability of RCM. Methods: Twelve KS lesions underwent RCM followed by histological examination. Data obtained were statistically correlated. Results: Analysis of the incidence of 11 selected microscopic criteria (by RCM and optical histology: inflammatory cells in the epidermis and in the dermis, single or in aggregates; spindle cells; stroma; anastomosing, newborn, increased number and dilated vessels; extravasated erythrocytes; deposits of hemosiderin) was performed disclosing a good correlation and high sensitivity of RCM. Conclusion: In our study RCM seems to provide high accuracy to predict histological findings, demonstrating its possible role in the management of patients affected by KS.

Optical Coherence Tomography as a Valuable Tool for the Evaluation of Cutaneous Kaposi Sarcoma Treated with Imiquimod 5% Cream

“…Utilizing the distinctive contrast offered by melanin and melanosomes in RCM images, this technique facilitates a microscopic analysis of tissue morphology in both healthy skin and melanocytic lesions, effectively providing a “virtual” skin biopsy with detailed en-face views of various skin layers [ 16 ]. In the context of KS, three specific features exclusively evident at RCM examination were identified, described, and considered: disappearance of the normal papillary ring structures at the dermoepidermal junction level named non-rimmed papillae; disarrangement of dermal normal structures with a collection of newborn vessels, spindle, and inflammatory cells named dermal granulation-like tissue; and ill-defined fusiform, linear, or fibrillar crossing bands with stronger brightness than normal collagen and elastic fibers named irregular net-like fascicles [ 20 ].…”

Full-Field Optical Coherence Tomography: A New Technology for 3D High-Resolution Skin Imaging

“…Confocal imaging was first applied to skin imaging in 1993 [7] in reflectance mode (detection of the light directly back-scattered by the tissue), then in fluorescence mode (detection of the light fluoresced by the tissue) [8]. In vivo confocal microscopy allows for examination of the epidermis and the papillary dermis at a resolution approaching histological detail, thus representing a new step towards accurate non-invasive diagnostics [9,10]. Multiphoton microscopy is another method which uses the properties of non-linear optics: in particular, second-harmonic generation emission is proportional to the square of the excitation light, and thus limits the emitting area to the focused illumination spot in the tissue [11].…”