Chapter 32: Reflectance Confocal Microscopy: the Era of Noninvasive Imaging

What is the approximate maximum depth of visualization of skin structures by confocal microscopy?

A. 20-50 microns (epidermis)

B. 200-250 microns (upper dermis)

C. 500-1000 microns (deeper dermis)

D. more than 2 mm (subcutis)

B. 200-250 microns (upper dermis)

Which of the following descriptions corresponds to atypical keratinocytes in epithelial tumors visualized by confocal microscopy?

A. Irregular honeycombed pattern, with poligonally shaped cells variable in size and shape and with pleomorphic nuclei

B. Irregular cobblestone pattern, with bright large and nucleated cells

C. Complete disarrangement of the epidermis with absence of any pattern

D. Presence of amorphous material in the epidermal layers

A. Irregular honeycombed pattern, with poligonally shaped cells variable in size and shape and with pleomorphic nuclei

Identify the following structures specific for the diagnosis of basal cell carcinoma:

A. Dense and sparse nests

B. Polycyclic papillary contours

C. Islands and/or cords with palisading

D. Meshwork pattern at the dermal epidermal junction

C. Islands and/or cords with palisading

Confocal microscopy is most likely to detect the following features of a melanocytic nevi:

A. Single melanocytes at the junction because of their dendritic appearance

B. Melanocytic nests at the junction and in the upper dermis

C. Nevocyte maturation

D. Eumelanin and pheomelanin formation

B. Melanocytic nests at the junction and in the upper dermis

The most characteristic confocal features of a melanoma are:

A. Presence of large bright nucleated cells in the epidermis and atypical melanocytes in a disarranged junctional architecture

B. Lack of maturation with depth

C. Presence of mitoses

D. Ulceration and neoangiogenesis

A. Presence of large bright nucleated cells in the epidermis and atypical melanocytes in a disarranged junctional architecture