M. Marinkovich, Postdoctoral Faculty Sponsor
BACKGROUND: Ex vivo confocal laser scanning microscopy (ex vivo CLSM) provides rapid, high-resolution imaging and immunofluorescence examinations of the excised tissues.OBJECTIVES: Evaluating the applicability of ex vivo CLSM in histomorphological and direct immunofluorescence (DIF) examination of pemphigus vulgaris (PV).METHODS: 20 PV sections were stained with fluorescent-labelled anti- IgG and anti-C3 using various dilutions and incubation periods. Subsequently, the determined ideal staining protocol was applied on 20 additional PV and 20 control sections.RESULTS: Ex vivo CLSM identified intraepidermal blisters and acantholytic cells in 80% and 60% of PV patients, respectively. The sensitivity of ex vivo CLSM in detecting intraepidermal fluorescence was 90% both with IgG and C3. The specificity of staining for IgG and C3 was 70% and 90%, respectively.CONCLUSION: Histomorphological and immunofluorescence features of PV could be detected within the same ex vivo CSLM session showing a comparable performance to conventional histopathology and DIF microscopy. This article is protected by copyright. All rights reserved.
View details for DOI 10.1002/jbio.202000509
View details for PubMedID 33491324
BACKGROUND: Ex vivo confocal laser scanning microscopy (CLSM) offers real-time examination of excised tissue in reflectance, fluorescence and digital hematoxylin-eosin (H&E)-like staining modes enabling application of fluorescent-labelled antibodies.OBJECTIVES: To assess the diagnostic performance of ex vivo CLSM in identifying histopathological features and lupus band test in cutaneous lupus erythematosus (CLE) with comparison to conventional histopathology and direct immunofluorescence (DIF).MATERIAL AND METHODS: 72 sections of 18 CLE patients were stained with acridine orange (AO), anti-IgG, -IgM and -IgA; 21 control samples were stained with AO. Subsequently, ex vivo CLSM examination of all samples was performed in reflectance, fluorescence and digital H&E-like staining modes.RESULTS: Superficial and deep perivascular inflammatory infiltration (94.4%), interface dermatitis (88.9%), spongiosis (83.3%) and vacuolar degeneration (77.7%) were the most common features detected with ex vivo CLSM. Kappa test revealed a level of agreement ranging within "perfect" to "good" between ex vivo CLSM and conventional histopathology. ROC analysis showed that the combination of perivascular infiltration, interface dermatitis and spongiosis detected by ex vivo CLSM has the potential to distinguish between CLE and controls. Basement membrane immunoreactivity with IgG, IgM and IgA was identified in 88.8% (n=15), 55.5% (n=10) and 55.5% (n=10) of the CLE samples using ex vivo CLSM, respectively. Whereas, DIF showed IgG, IgM and IgA positivity in 94.4% (n=17), 100% (n=18) and 88.9% (n=16) of patients, respectively.CONCLUSION: Ex vivo CLSM enables simultaneous histopathological and immunofluorescence examination in CLE showing a high agreement with conventional histopathology, albeit with a lower performance than conventional DIF.
View details for DOI 10.1111/exd.14265
View details for PubMedID 33345402
Ex-vivo confocal laser scanning microscopy (CLSM) provides rapid, high-resolution imaging, fluorescence detection and digital hematoxylin-eosin (H&E)-like staining.Assessing the performance of ex-vivo CLSM in identifying histomorphology and immunoreactivity in lichen planus (LP) and comparing its accuracy with conventional histopathology and direct immunofluorescence (DIF).33 sections of 17 LP patients stained with acridine orange (AO) and FITC-labelled anti-fibrinogen antibody and 21 control samples stained with AO were examined using ex-vivo CLSM.Ex-vivo CLSM was in perfect agreement with conventional histopathology in identifying interface dermatitis, vacuolar degeneration and band-like infiltration. ROC analysis showed that the presence of vacuolar degeneration, interface dermatitis and band-like infiltration was useful to distinguish LP sections from controls (p<0.0001). The detection rates of fibrinogen deposition using DIF and ex-vivo CLSM were 93.8% and 62.5%, respectively.Ex-vivo CLSM enables histopathological and immunofluorescence examination in LP with the advantage of digital H&E-like staining. This article is protected by copyright. All rights reserved.
View details for DOI 10.1002/jbio.202000328
View details for PubMedID 33025741