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Updated: Aug 9, 2026
Combining Reflectance Confocal Microscopy with Optical Coherence Tomography for Noninvasive Diagnosis of Skin Cancers via Image Acquisition
Published on: August 18, 2022
Reflectance confocal microscopy of pigmented basal cell carcinoma
Anna Liza Chan Agero1, Klaus J Busam, Cristiane Benvenuto-Andrade
1Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, New York 10022, USA.
Background:
Reflectance confocal microscopy (RCM) is a high-resolution imaging tool for in vivo noninvasive evaluation of skin lesions.
Objective:
We sought to describe the relevant RCM features for pigmented basal cell carcinoma (BCC).
Methods:
Pigmented skin lesions with a differential diagnosis of pigmented BCC were imaged using dermoscopy and RCM, followed by excision for histologic analysis.
Results:
RCM demonstrated aggregations of tightly packed cells with palisading, forming cordlike structures and nodules with irregular borders and variable brightness; these represented nests of pigmented basaloid tumor cells on histopathology, and blue-gray ovoid areas on dermoscopy. These tumor nests were associated with bright dendritic structures, identified histologically as either melanocytes or Langerhans cells, together with numerous bright oval to stellate-shaped structures with indistinct borders representing melanophages, and with highly refractile granules of melanin.
Limitations:
The pigmented BCCs imaged in this study were predominantly nodular; a different set or additional criteria may be necessary for detection of infiltrative and metatypical BCCs.
Conclusion:
RCM may permit in vivo diagnosis of pigmented BCC.
