Table 5.
Key articles comparing confocal microscopy and histopathology.
| Tumor type | Year | Type | Main findings | Correlation with histopathological findings | Sample size |
|---|---|---|---|---|---|
| Basal cell carcinoma (BCC) (31) | 2002 | Real-time, confocal reflectance microscopy (in vivo) | Confocal features correlated very well with hematoxylin and eosin (H&E)-stained sections of the biopsy specimen | Features that were readily identified by both in vivo confocal microscopy and standard microscopy of H&E-stained sections included parakeratosis, actinic changes overlying the BCC, relative monomorphism of BCC cells, BCC nuclei exhibiting characteristic elongated or oval appearance, high nucleocytoplasmic ratios, and the presence of prominent nucleoli, increased vascularity, and prominent predominantly mononuclear inflammatory cell infiltrate | 8 BCC lesions |
| Actinic keratosis (AK), squamous cell carcinoma (SCC), keratoacanthoma (32) | 2009 | Reflectance confocal microscopy (in vivo) | All 38 cases displayed an atypical honeycomb and/or disarranged pattern of the spinous-granular layer of the epidermis; round nucleated cells were seen in 20 SCCs (65%) and 1 AK (14%) Round blood vessels were seen in the superficial dermis in 28 SCCs (90%) and 5 AKs (72%) | Round nucleated cells at the spinous-granular layer correspond to atypical keratinocytes or dyskeratotic cells | A total of 38 lesions in 24 patients with 7 AKs, 25 SCCs in situ, 3 invasive SCCs, and 3 keratoacanthomas |
| Bowen disease (BD) (33) | 2012 | Reflectance confocal microscopy (in vivo) | Two types of targetoid cells were seen: those presenting as large, homogeneous, bright cells with a dark halo; and round ones with a dark center, surrounding bright rim, and dark halo | Targetoid cells correlated dyskeratotic cells with condensed, eosinophilic cytoplasm and a retraction halo. Dyskeratotic cells were correlated with a dark central nucleus and a surrounding clear retraction halo | 10 cases of BD |
| BCC (34) | 2013 | Comparison of reflectance confocal microscopy and multiphoton tomography findings (in vivo) | Elongated cells and palisading structures are easily recognized using both methods | Due to the higher resolution, changes in nucleus diameter or cytoplasm could be visualized using multiphoton tomography (MPT) Therefore, nucleus diameter, nucleus/cytoplasm ratio, and cell density are estimated for normal and BCC cells using MPT | 9 patients with BCC |