Table 2. RCM Features Findings of Pigmented Lesions on the Lipsa.
| RCM Feature | No. (%) | P Value | |
|---|---|---|---|
| Melanotic Macules (n = 16) |
Melanomas (n = 6) |
||
| Suprabasal Epidermis | |||
| Regular architectural patterns | 15/16 (94) | 2/6 (33) | .009 |
| Regular HC pattern | 15/16 (94) | 2/6 (33) | .009 |
| Cobblestone pattern | 2/16 (13) | 0/6 (0) | >.99 |
| Atypical architectural patterns | 7/16 (44) | 6/6 (100) | .046 |
| Epidermal disarray, disarranged pattern | 5/16 (31) | 6/6 (100) | .01 |
| Atypical HC | 3/16 (19) | 4/6 (67) | .05 |
| HC Atypical and disarray | 3/16 (19) | 4/6 (67) | .05 |
| Broadened HC | 2/16 (13) | 0/6 (0) | >.99 |
| Diamond shape HC pattern with irregular diamond-shaped large cells, >20 μm | 1/16 (6) | 0/6 (0) | >.99 |
| Atypical cobblestone pattern | 1/16 (6) | 2/6 (33) | .17 |
| Other findings | |||
| Corneal cyst | 0/16 (0) | 0/6 (0) | |
| Grainy image | 7/16 (44) | 1/6 (17) | .35 |
| Presence of Pagetoid cells | 4/16 (25) | 6/6 (100) | .003 |
| Pleomorphism, variability of pagetoid cell morphology | 1/4 (25) | 3/6 (50) | .57 |
| Density of pagetoid cells | |||
| Classification 1 | |||
| Low: <5 cells/mm2 | 2/4 (50) | 3/6 (50) | >.99 |
| Moderate: 5-10 cells/mm2 | 2/4 (50) | 1/6 (17) | .50 |
| High: >10 cells/mm2 | 0/4 (0) | 2/6 (33) | .47 |
| Classification 2 | |||
| >3 Pagetoid cells in five (0.5 × 0.5mm2) images | 1/4 (25) | 4/6 (67) | .52 |
| >3 Pagetoid cells in a cluster | 0/4 (0) | 3/6 (50) | .20 |
| Distribution of pagetoid cells | |||
| Localized | 2/4 (50) | 3/6 (50) | >.99 |
| Sparse | 2/4 (50) | 1/6 (17) | .50 |
| Widespread | 0/4 (0) | 2/6 (33) | .47 |
| Other | |||
| Dark pagetoid cells (hyporeflective) | 0/16 (0) | 0/6 (0) | |
| Widespread pagetoid infiltration | 0/16 (0) | 2/6 (33) | .06 |
| Round pagetoid cells | 0/16 (0) | 3/6 (50) | .01 |
| Dendritic pagetoid cells | 4/16 (25) | 5/6 (83) | .02 |
| Dermal Epidermal Junction | |||
| Architectural patterns | |||
| Ringed pattern | 16/16 (100) | 4/6 (67) | .06 |
| Polycyclic papillae | 12/16 (75) | 2/6 (33) | .14 |
| Meshwork pattern | 0/16 (0) | 1/6 (17) | .27 |
| Clod pattern | 0/16 (0) | 0/6 (0) | |
| Nonspecific pattern | 1/16 (6) | 3/6 (50) | .046 |
| Trabecullar pattern or draped pattern | 11/15 (73) | 3/6 (50) | .61 |
| Distribution of papillae | |||
| Homogeneously distributed papilllae | 12/16 (75) | 1/6 (17) | .02 |
| Nonhomogeneously distributed papillae | 4/16 (25) | 5/6 (83) | .02 |
| Papillae/interpapillary space | |||
| Edged papillae | 9/16 (56) | 1/6 (17) | .16 |
| Papillae rimmed by highly reflective epithelial cells | 7/16 (44) | 1/6 (17) | .35 |
| Nonedged papillae | 16/16 (100) | 6/6 (100) | |
| Absence of a hyperreflective basal layer and presence 2-3 dendritic bright cells per papillae | 15/16 (94) | 3/6 (50) | .046 |
| Pearl necklace | 0/16 (0) | 1/6 (17) | .27 |
| Continuous (lentiginous) proliferation of atypical enlarged bright cells | 2/16 (13) | 5/6 (83) | .004 |
| Nonvisible papillae | 3/16 (19) | 3/6 (50) | .28 |
| Large interpapillary space | 0/16 (0) | 0/6 (0) | |
| Cellular atypia | 16/16 (100) | 6/6 (100) | |
| General characteristics of large visible atypical cells | |||
| Nonpleomorphic monomorphous small cells typical | 0/16 (0) | 0/6 (0) | |
| Mild cellular atypia | 14/16 (88) | 0/6 (0) | <.001 |
| Marked cellular atypia | 3/16 (19) | 6/6 (100) | .001 |
| More than 3 atypical cells at the junction in 5 images, field of view 0.5 × 0.5 mm | 14/16 (88) | 6/6 (100) | >.99 |
| Numerosity 1 | |||
| Low (<5 cells/mm2) | 2/16 (13) | 0/6 (0) | >.99 |
| Moderate (5-10 cells/mm2) | 2/16 (13) | 0/6 (0) | >.99 |
| High (>10 cells/mm2) | 12/16 (75) | 6/6 (100) | .54 |
| Numerosity 2: Number of atypical cells in 1 mm2, (SD) | 18.20 (11.38) | 88.2 (115.71) | .02 |
| Numerosity, >20 dendritic cells in 1 mm2 or four 0.5 × 0.5 mm fields of view | 6/15 (40) | 5/5 (100) | .04 |
| Numerosity, >30 dendritic cells in 1 mm2 or four 0.5 × 0.5 mm fields of view | 2/15 (13) | 3/5 (60) | .07 |
| Numerosity, >40 dendritic cells in 1 mm2 or four 0.5 × 0.5 mm fields of view | 1/15 (7) | 2/5 (49) | .14 |
| Numerosity 3: maximun number dendritic cells per papillae | |||
| ≤2 cells | 5/15 (33) | 1/5 (20) | >.99 |
| 3-4 cells | 10/15 (67) | 2/5 (40) | .35 |
| ≥5 cells | 0/15 (0) | 2/5 (40) | .05 |
| Aspect of atypical cells | |||
| Atypical cells with dark halo | 0/16 (0) | 1/6 (17) | .27 |
| Atypical dendritic cells | 16/16 (100) | 5/6 (83) | .27 |
| Atypical round cells | 1/16 (6) | 5/6 (83) | .001 |
| Distribution of atypical cells | |||
| Localized | 1/16 (6) | 1/6 (17) | .48 |
| Sparse | 15/16 (94) | 3/6 (50) | .046 |
| Widespread | 0/16 (0) | 2/6 (33) | .06 |
| Distribution of atypical cells in relationship with the papillae | 15/16 (94) | 6/6 (100) | |
| Peripapillar | 14/16 (88) | 6/6 (100) | >.99 |
| Interpapillar | 6/16 (38) | 6/6 (100) | .02 |
| Morphology of dendritic cells-1 | 16/16 (100) | 5/6 (83) | |
| Elongated | 16/16 (100) | 4/5 (80) | .24 |
| Plump | 8/16 (50) | 5/5 (100) | .11 |
| Moderate-high amount of plump cells | 6/16 (38) | 5/5 (100) | .04 |
| Both | 8/16 (50) | 5/5 (100) | .11 |
| Morphology of dendritic cells-2 | 16/16 (100) | 5/6 (83) | |
| Stellate | 16/16 (100) | 4/5 (80) | .24 |
| Moderate-high amount stellate cells | 16/16 (100) | 2/5 (40) | .008 |
| Triangular | 8/16 (50) | 2/5 (40) | >.99 |
| Fusiform | 10/16 (63) | 4/5 (80) | .62 |
| Roundish | 2/16 (13) | 5/5 (100) | .001 |
| Cytomorphology of dendritic cells | |||
| Body area | |||
| Average area soma, (SD), μm2 | 123.13 (31.92) | 260.42 (60.86) | .002 |
| Soma area >150 μm2 | 4/16 (25) | 3/5 (60) | .28 |
| Soma area >160 μm2 | 2/16 (13) | 5/5 (100) | .001 |
| Soma area >200 μm2 | 0/16 (0) | 4/5 (80) | <.001 |
| Body length | |||
| Average length, (SD) | 16.56 (2.60) | 21.08 (3.06) | .01 |
| Length >19 μm | 4/16 (25) | 4/5 (80) | .048 |
| Length >20 μm | 2/16 (13) | 4/5 (80) | .01 |
| Body width | |||
| Average width, (SD) | 8.93 (1.82) | 14.14 (2.17) | .002 |
| Width >12 μm | 1/16 (6) | 4/5 (80) | .004 |
| Ratio length/width | |||
| Average ratio length/width, (SD) | 1.90 (0.35) | 1.50 (0.13) | .01 |
| Ratio length/width >1.7 | 10/16 (63) | 1/5 (20) | .15 |
| Ratio length/width >1.8 | 9/16 (56) | 0/5 (0) | .045 |
| Junctional changes | 0/16 (0) | 3/6 (50) | .01 |
| Junctional nest | 0/16 (0) | 1/6 (17) | .27 |
| Junctional clusters, 3 or 4 cells | 0/16 (0) | 3/6 (50) | .01 |
| Junctional thickenings | 0/16 (0) | 2/6 (33) | .06 |
| Sheet of cells | 1/16 (6) | 3/6 (50) | .046 |
| Papillary Dermis | |||
| Nests/other collections of cells | 0/16 (0) | 1/6 (17) | .27 |
| Regular dense nest | 0/0 (0) | 0/6 (0) | |
| Dishomogenous nest (dense and sparse nests) | 0/0 (0) | 0/6 (0) | |
| Cerebriform nest | 0/0 (0) | 0/6 (0) | |
| Sparse cell nests | 0/16 (0) | 1/6 (17) | .27 |
| Nucleated cells within tumor islands | 0/16 (0) | 1/6 (17) | .27 |
| Nucleated cells within the papilla | 1/16 (6) | 2/6 (33) | .17 |
| Plump bright cells within the papillae | 16/16 (100) | 5/6 (83) | .27 |
| Plump bright cells in large aggregation within the papillary dermis | 13/16 (81) | 2/6 (33) | .05 |
| Plump bright cells and/or small bright particles in papillae | 15/16 (94) | 5/6 (83) | .48 |
| Plump bright cells sparse | 11/16 (69) | 4/6 (67) | >.99 |
| Plump bright cells confluent | 6/16 (38) | 1/6 (17) | .62 |
| Big, round bright cells within the papillae | 7/16 (44) | 0/6 (0) | .12 |
| Big, dendritic, bright within the papillae | 7/16 (44) | 0/6 (0) | .12 |
| Vessels | |||
| Vessels visible | 16/16 (100) | 4/6 (67) | .06 |
| Horizontal vessel | 0/0 (0) | 0/6 (0) | |
| Convoluted glomerular-like vessel | 0/16 (0) | 0/6 (0) | |
| Fibers | Evaluable in 8/9 | Evaluable in 4/6 | |
| Collagen bundles | 2/9 (22) | 3/4 (65) | .22 |
| Reticulated fibers | 8/9 (89) | 1/4 (25) | .05 |
| Broadened reticulated collagen fibers | 0/9 (0) | 2/4 (50) | .08 |
| Thick cordons | 0/9 (0) | 0/4 (0) | |
| Other findings | |||
| Network of dendritic cells and dendritic procesess | 6/16 (38) | 1/6 (17) | .62 |
| Small basal pigmented cells (keratinocytes) | 11/16 (69) | 2/6 (33) | .18 |
Abbreviations: HC, honeycombed; RCM, reflectance confocal microscopy.
a
The following RCM features for basal cell carcinomas were scored, but because they were negative were not included in the table: polarized in the HC, epidermal shadow, dendriticlike features within tumor islands, basaloid cord or nodules, fibrillar polarized pattern around tumor, linear telangiectasialike horizontal vessel, clefting.