Morphological features of Spitz naevus as observed by digital videomicroscopy

A characteristic epiluminescence pattern of pigmented epithelioid and/or spindle cell naevus, or Spitz naevus, has been described previously. The aim of this study was (i) to evaluate the characteristic morphological features both of pigmented and non-pigmented epithelioid and/or spindle cell naevi observed employing a videomicroscope, (ii) to identify their histopathological correlates and (iii) to assess the improvement in diagnostic accuracy for epithelioid and/or spindle cell naevi obtained by means of this new instrumental device. Clinical, videomicroscopic and histopathological diagnoses were performed on 26 epithelioid and/or spindle cell naevi. Moreover, the videomicroscopic pattern of each lesion was described using appropriate morphological parameters. Based on their morphological aspect detected by digital videomicroscopy, epithelioid and/or spindle cell naevi can be subdivided into three main groups: (i) darkly pigmented lesions, (ii) red or light brown ESC naevi, and (iii) lesions with dark or brown areas on a light-brown background. Whereas most epithelioid and/or spindle cell naevi of the spindle cell type belonged to the morphological group I and group 3, most epithelioid cell lesions appeared as red or light-brown coloured naevi. Finally, instrumental observation by means of a videomicroscope enabled an improvement in diagnostic accuracy with respect to the naked eye observation, with an increase in sensitivity from 15% to 58%

Primary Mandibular Condyle Xanthoma: Case Report and Literature Review

Bone xanthoma is a rare benign primary bone lesion histologically characterized by sheets of foamy cells which are macrophages with a cytoplasm filled with droplets of fat. It is usually associated with endocrine or metabolic diseases, in the absence of which the lesion is called primary xanthoma. Because of the lack of pathognomonic radiologic and clinical features, they require a differential diagnosis with a broad spectrum of lesions with a varying degree of malignant potential. We describe a case of primary mandibular xanthoma of a 16-year-old girl without typical cutaneous manifestations and alterations in lipid values. The temporomandibular joint involvement at the mandibular condyle is peculiar in the case described here. We present even a qualitative systematic review of the literature on primary xanthoma of the jaws in others to draw up treatment guidelines

Design of monolithically integrated InGaAsP/InP passively-modelocked linear quantum well lasers in an active-passive integration scheme

In this paper simulation results of Fabry-Perot mode-locked lasers are presented that are based on measured modal gain data of InGaAsP quantum well optical amplifiers. Gain spectra were measured for various values of injected current density. The gain spectra were fitted to an analytical formula to describe the spectra using a few parameters. These were used as input parameters in a series of simulations of mode-locked lasers. The performance of three-section passively mode-locked lasers (amplifier, saturable absorber and passive waveguide) was studied for various lengths of the absorber and passive waveguide sections as well as various reflectivity values of the resonator mirrors

Combined use of dermoscopy, reflectance confocal microscopy and ex-vivo gene expression profiling to detect a micro-melanoma less than 1 mm in diameter

.Micro-melanomas, or melanomas < 2 mm in diameter, are increasingly reported making screening methods like the ABCD(E) acronym outdated. Early detection of melanoma remains the utmost important prognostic factor, therefore understanding how to utilize different diagnostic tools is necessary to optimize detection of melanoma at its earliest, most treatable stage. Using a combination of imaging and molecular techniques, we detected and confirmed a micro-melanoma in situ measuring 0.65 mm in diamete

Mullitization behaviour during thermal treatment of three kaolinitic clays from Cameroon: Densificaron, sintering kinetics and microstructure

Three kaolinitic clays from Cameroon were studied for their mullitization behaviour. The three clayey materials were from Ntamuka (TAN), Mayouom (MAY) and Wabane (WAB), all situated in the hills of western Cameroon. X-ray diffraction and thermal, dilatometric and SEM-EDS analyses were used to follow up the phase evolution, sintering kinetics and microstructure of the three materials as a function of temperature (1000-1500°C). Fine powders of each sample were pressed and treated in the above temperature range with the goal to correlate the phase evolution with densificaron parameters (shrinkage, porosity, density and mechanical strength). The nucleation of mullite and the increase of peak intensities were directly correlated to continuous densification and reduction of open porosity as observed under the SEM, The mullitization peak temperatures at 5°C/min were 973°C, 979.1°C, and 983.6°C respectively for TAN, MAY and WAB and - in the same order but at 20°C/min 992.1°C, 997.4°C and 1001.2°C. The mullitization phenomenon, which includes a first step of nucleation and a second of crystal growth, shows an activation energy that varies depending on the nature of sample investigated: the values ranged from 650 to 730 kJ/mol. The microstructure of the sintered products consisted on the elongated secondary mullite (types II and III) interlocking with primary (type I) mullite in a compact matrix with relative amount of glassy phase for MAY and WAB. The morphology of mullite grains in TAN was more different being laiger cuboid grains aggregated with cristobalite to form a compact microstructure. The formation of TiO2 crystals and then Ti-Al (tialite: Al2TiO5) crystals influenced the microstructure of MAY and WAB

Improving diagnostic accuracy of dermoscopically equivocal pink cutaneous lesions with reflectance confocal microscopy in telemedicine settings : double reader concordance evaluation of 316 cases

Solitary pink lesions in differential diagnosis with hypopigmented/amelanotic melanoma present a diagnostic challenge in daily practice and are regularly referred for second expert opinion. Reflectance confocal microscopy (RCM) has been shown to improve diagnostic accuracy of dermoscopically equivocal pink lesions. No studies have been performed to evaluate the effect of adding a second expert reader and automatic removal of lesions with discordant management recommendations and its potential effect on diagnostic sensitivity and final management of these lesions in retrospective or telemedicine settings.To improve diagnostic accuracy and reduce potential mismanagement of dermoscopically equivocal pink cutaneous lesions by implementing double reader concordance evaluation of RCM images.316 dermoscopically equivocal pink lesions with dermoscopy-RCM image sets were evaluated retrospectively. Accuracy of three readers was evaluated by single reader evaluation of dermoscopy only and dermoscopy-RCM image sets and finally by double reader evaluation of dermoscopy-RCM image sets. Lesions with discordant diagnosis between two readers were automatically recommended for excision.Dermoscopy only evaluation resulted in an overall sensitivity of 95.9% and specificity of 33.6%, with 1 of 12 amelanotic melanomas mismanaged. Dermoscopy-RCM image set single reader evaluation resulted in an overall sensitivity of 93.9% and overall specificity of 54.2%, with 1 of 12 melanomas mismanaged. Dermoscopy-RCM image set double reader concordance evaluation resulted in an overall sensitivity of 98.3% and specificity of 42.7%, with no amelanotic melanoma mismanagement.Evaluation of dermoscopy-RCM image sets of equivocal pink lesions by a single reader in telemedicine settings is limited by the potential for misdiagnosis of dangerous malignant lesions. Double reader concordance evaluation with automatic referral of lesions for removal in the case of discordant diagnosis improves the diagnostic sensitivity in this subset of lesions and reduce potential misdiagnosis in settings where a second expert opinion may be employed

Three roots of melanoma

Segura et al1 describe morphologic features of melanomas with a nodular component using in vivo reflectance-mode confocal microscopy (RCM) and correlate these RCM findings with histopathologic findings. The most striking observation made by the investigators is the remarkable difference in epidermal involvement between nodular melanoma (NM) and superficial spreading melanoma (SSM) with a nodular component. At RCM, SSMs frequently showed epidermal disarrangement and pagetoid infiltration, whereas NMs exhibited a preserved epidermal pattern and few pagetoid cells.1 This new observation provides fertile ground for revisiting the conventional concept of melanoma development. We propose an alternative hypothesis based on recent observations made in stem cell research and demonstrate how this hypothesis can better account for the observed clinical and epidemiologic differences between melanoma subtypes

Dermoscopy, Reflectance Confocal Microscopy and Optical Coherence Tomography Features of Acne: A Systematic Review

Noninvasive imaging techniques have recently outlined precise microscopic features of acne elementary lesions and accurate quantifications for disease severity staging and therapeutical efficacy follow-up. The aim of this review is to systematically describe current applications of dermoscopy, reflectance confocal microscopy (RCM), and optical coherence tomography (OCT) in acne vulgaris assessment and management. The study followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. We included studies conducted on human subjects with elementary lesions of acne vulgaris, reporting assessment of the lesions with dermoscopy, RCM, and/or OCT. At present there are few large studies regarding acne and noninvasive imaging techniques, representing the main limitation of this review. Clinical examination represents the first line in acne diagnosis and treatment. However, dermoscopy, RCM, and OCT are further tools that can improve acne classification, monitoring of treatment, and pathophysiologic characterization. In the near future, dermoscopy, RCM, and OCT could become routinely used for the evaluation of acne vulgaris to provide a deeper knowledge of the disease and to guide the clinician in the prescription of tailored treatment protocols based on each patient’s characteristics

CD271 is expressed in melanomas with more aggressive behaviour, with correlation of characteristic morphology by in vivo reflectance confocal microscopy

Background Melanoma is the most highly aggressive type of skin cancer. Its resistance to existing treatments and the rapid rise in incidence underscore the importance of acquiring a better understanding of melanomagenesis. Objectives To assess the impact of reflectance confocal microscopy (RCM) on the description of cell morphology, which may influence the growth pattern and changes with increasing tumour severity, correlating with biological aspects. Methods A retrospective analysis of 30 primary melanomas in vivo, evaluated by RCM, to correlate cell morphology and cellular arrangement with a marker of melanoma progression (CD271) using immunohistochemical evaluations. Results Typical cells organized in dermal nests with peculiar in vivo confocal morphology result in melanoma with high malignancy and positivity to CD271. This architecture might be due to the presence of a type of cells, intrinsically predisposed to invasion, as a result of dedifferentiation programming, revealed by expression of the neural crest marker CD271. Conclusions With the hypothesis that dedifferentiated cells would be strongly responsible for initiation of tumour development and progression, we propose that CD271 detection could be associated with RCM evaluation in order to detect more aggressive melanoma subtypes