Reflectance Confocal Microscopy May Enhance the Accuracy of Histopathologic Diagnosis | PracticeUpdate

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Reflectance Confocal Microscopy May Enhance the Accuracy of Histopathologic Diagnosis

• The authors reported a series of 9 cases in which histopathologic diagnosis of a malignant neoplasm (5 melanomas in situ, 3 melanomas, 1 pigmented BCC) were aided using bedside reflectance confocal microscopy (RCM). RCM was recently assigned Category I CPT codes, allowing clinicians to bill for its bedside use.

• Therefore, the authors concluded that increased use of RCM may eventually result in fewer missed histopathologic diagnoses as well as fewer unnecessary biopsies.

– Caitlyn T. Reed, MD

abstract

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Although histopathology is the time-honored gold standard diagnostic measure in dermatology, several factors may detract from an accurate microscopic diagnosis. Limiting factors include: human error, suboptimal biopsy-site selection or biopsy technique, and inherent restrictions of vertical tissue sectioning that lead to incomplete microscopic evaluation of the lesion. Reflectance confocal microscopy (RCM) is a non-invasive imaging tool that allows for the cellular-level examination of the lesion, at a horizontal plane, which may complement the subsequent vertical histopathological tissue examination. Herein, we report a case series whereby pre-biopsy RCM examination enhanced the accuracy of histopathological diagnosis or allowed for a critical appraisal of initial histopathological misdiagnosis. This article is protected by copyright. All rights reserved.

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Benjamin Hidalgo-Matlock
Skin Care Physicians of Costa Rica

Clinica Victoria en San Pedro: 4000-1054
Momentum Escazu: 2101-9574

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