Table 3:
Breakdown of reflectance confocal microscopy terms for melanocytic neoplasms into basic terminology units. Abbreviations: DEJ = dermo epidermal junction.
| Cells / structures | Morphology modifiers/Descriptors | Anatomic location /Distribution |
|---|---|---|
| Relates to melanocytes as individual cells | ||
| Atypical cells | Dendritic | Pagetoid spread |
| Atypical melanocytes | Enlarged | Pagetoid pattern |
| Bright nucleated cells | Hyporeflective/dark | Pagetoid infiltration |
| Cell atypia | Irregularly bright | Widespread |
| Cells (NOS**) | Large | Focal |
| Cellular atypia | Pleomorphic | Folliculotropism |
| Cytological atypia | Round | Infiltrating adnexal structures |
| Melanocytic cells | Spindled | Non-specified |
| Melanocytes | With halo | In the dermal papillae |
| Nucleated cells | At the DEJ | |
| Pagetoid cells | Dermal infiltration | |
| Infiltrating papillary dermis | ||
| At the periphery | ||
| Relates to dendritic processes without visible cell body | ||
| Branching dendrites * | Composite dendrites | |
| Dendritic processes * | Simple dendrites | |
| Tangled lines * | Coarse dendrites | |
| Relates to aggregated melanocytes | ||
| Aggregates of atypical cells | Cerebriform | Around the hair follicle |
| Bulging | Dense | Junctional |
| Cells clusters | Dense and sparse | Dermal |
| Clods | Dense dishomogeneous | |
| Clusters | Dense irregular | |
| Junctional thickening | Discohesive | |
| Medusa head-like | Dishomogeneous | |
| Melanocytic cell nests | Irregular | |
| Mitochondria-like structures | Marked pleomorphism (within nest) | |
| Nesting | Non-homogeneous | |
| Nests | Pleomorphism (within nest) | |
| Sheet-like | Sparse | |
| Related to keratinocytes | ||
| Acanthosis | Atypical | |
| Basal cells | Broadened (Honeycomb) | |
| Cobblestone pattern | Irregular | |
| Epidermal disarray | Monomorphic | |
| Epidermal pattern | Poorly-defined | |
| Honeycomb pattern | Readily detected | |
| Keratinocyte cell borders | Regular | |
| Refractile cells | Typical | |
| Relates to DEJ structures/shape | ||
| DEJ disarray | Absent | |
| Dermal papillae | Edged | |
| Papillae | Loss of (papilla / papillary contour) | |
| Papillary contours | Non-edged | |
| Non-visible | ||
| Poorly visualized | ||
| Ringed | ||
| Relates to stromal structures | ||
| Inflammatory cells | ||
| Bright dots | Round-to-triangular | Dermal |
| Bright non-nucleated cells | ||
| Bright particles | ||
| Bright small cells | ||
| Bright spots | ||
| Dermal bright cells | ||
| Inflammatory infiltrate | ||
| Inflammation | ||
| Melanophages | ||
| Plump cells | ||
| Stromal fibers | ||
| Bright fibrillar structures | Broadened | |
| Collagen | Bundled | |
| Curled fibers | Coarse | |
| Fibroplasia | Reticulated | |
| Highly reflecting fibers | Thickened | |
| Stromal fibre | ||
| Thick cordons | ||
| Blood vessels | ||
| Vascularity | Atypical | |
| Vessels | Enlarged | |
| Horizontal | ||
| Irregular | ||
| Prominent | ||
| Tortuous morphology | ||
*
Dendritic structures is a descriptive term that can pertain to dendritic processes emanating from either melanocytes or from Langerhans cells
**
NOS – not otherwise specified; the context of the original term implies that “cells” refer to melanocytes.
***
‘Grainy image’ and ‘epidermal granularity’ are not included in the table.