המידע באדיבות מדיקונטקסט
Last Updated: 2001-07-25 9:53:01 EDT (Reuters Health)
By Anthony J. Brown, MD
WESTPORT, CT (Reuters Health) – Confocal scanning laser microscopy (CSLM) can detect clinically amelanotic melanoma in vivo, according to a report published in the July issue of the Archives of Dermatology. In addition to allowing earlier diagnosis, CSLM may provide a noninvasive means of assessing margins preoperatively.
Dr. Allan C. Halpern, from Memorial Sloan-Kettering Cancer Center, in New York City, and colleagues assessed the ability of CSLM to detect clinically amelanotic melanomas in two women. One patient had an unusually large primary lesion on her leg and the other patient had an erythematous patch on her cheek. After CLSM, biopsy specimens from the lesions were subjected to conventional histologic analysis.
Based on the CSLM images obtained, the researchers were able to distinguish abnormal melanocytic proliferation from normal skin. Comparison with the conventional histologic results revealed that "CSLM correctly identified intraepidermal melanoma and benign skin," Dr. Halpern's group reports.
"This is a noninvasive technique that images the skin in vivo with a resolution that allows us to see individual cells," Dr. Halpern told Reuters Health. "The resolution approaches that of real invasive histology," he noted. "There are many new imaging modalities, but none of them approach this kind of resolution," he stated.
"The trade-off with this technique is that the penetration is very limited," Dr. Halpern noted. "But because most of the important pathology for melanoma occurs very superficially at the dermal/epidermal junction, we can see it with this technique," he said.
Dr. Halpern noted that "other investigators have reported that melanocytes are easy to image with this technique." However, "it was always thought that it was because of the amount of pigment that was present," he explained. "In our study, we showed that the melanocytes were easily identified even when pigment was not present," he added.
"This is the kind of imaging modality that you might see in a physician's office down the road," Dr. Halpern said. "The CSLM can generate black-and-white near-histology images for interpretation by the physician or, more likely, the digital images could be sent directly to a pathologist for interpretation," he noted.
Arch Dermatol 2001;137:923-929.
-Westport Newsroom 203 319 2700
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