![]() ![]() ![]() a On dermoscopy, a papillomatous melanocytic nevus with structureless areas is observed in close association to a seborrheic keratosis (SK). Melanophages ( red arrow) and inflammatory cells ( white arrow) are observedĬommon acquired melanocytic nevus, compound deep type located on the back. g Junctional nest and dermal nests with roundish monomorphic cells are observed even at a depth with Z value of 258 μm. f Higher in the epidermis a cobblestone pattern is noticed ( Z = 20 μm). e On the corresponding en face HD-OCT image, the same features are present. Roundish monomorphic cells are infiltrating the junctional layer. d On the basic RCM image (0.5 × 0.5 mm) ( Z = 75 μm), a mixed ringed and meshwork pattern can be observed. c The cross-sectional HD-OCT imaging permits the visualization of the increased number of melanocytes in the basal layers and hyperpigmented basal keratinocytes. Dermal nests and cords of monomorphic melanocytes are present. Discrete melanocytic nests, composed by typical monomorphous cells located at the dermo-epidermal junction and within papillary dermis are noticed. b Routine histopathology shows elongated slightly irregular rete ridges with an increased number of melanocytes in the basal layers and hyperpigmented basal keratinocytes. a On dermoscopy, a typical pigment network (reticular pattern) and dark diffuse pigmentations (homogeneous pattern) are observed. On the HD-OCT en face images the border of a 2-mm diameter open plastic ring can be observed ( yellow arrow)Ĭommon acquired melanocytic nevus, compound superficial type located on the back. Red square in HD-OCT image = corresponding field of view of RCM. Z value = distance in μm from surface to focus location. f– g On the corresponding en face HD-OCT images ( Z = 25 μm and Z = 75 μm), the same features are seen despite the lower resolution. Some compact, monomorphic dense nests are present. No atypical cells are observed in these irregular junctional thickenings. The dark dermal papillae are irregular in size and shape. d– e On the basic RCM images ( Z = 30 μm left and Z = 72 μm right), a meshwork pattern is displayed with non-edged papillae. c The cross-sectional (cross-sectional) HD-OCT imaging demonstrates the pigmented rete ridges and bridging nests of melanocytic nests within the epidermis and papillary dermis as displayed in routine histopathology. Pigmented keratinocytes and transepidermal melanin loss is noticed. Elongated and parallel oriented epidermal cristae are observed at the periphery of the lesion. b Routine histopathology shows disarrangement of the rete ridges. a On dermoscopy, a wide irregular (atypical) pigment network (reticular pattern) can be observed. The diagnostic potential of HD-OCT regarding malignant melanoma is not high enough for ruling out a diagnosis of malignant melanoma.Ĭommon acquired melanocyt nevus, junctional nevus located on the back. The method appears to offer the possibility of additional three-dimensional structural information complementary to that of RCM, albeit at a slightly lower lateral resolution. HD-OCT provides morphological imaging with sufficient resolution and penetration depth to discriminate architectural patterns and cytologic features of pigmented cells in epidermis and dermis. Identification of architectural patterns in cross-sectional mode and cytologic features of pigmented cells in the epidermis, dermo-epidermal junction, papillary dermis, and superficial reticular dermis in the en face mode was possible by HD-OCT. Twenty-six melanocytic lesions of 26 patients were imaged. En face HD-OCT images were compared with reflectance confocal microscopy (RCM). Cross-sectional HD-OCT images were compared with histopathology. All lesions were examined by one observer clinically and using dermoscopy. The objective of this study was to evaluate HD-OCT for its ability to identify architectural patterns and cytologic features of melanocytic lesions. High-definition optical coherence tomography (HD-OCT) is a non-invasive in vivo imaging technique with cellular resolution based on the principle of conventional optical coherence tomography. ![]()
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