Cerebriform Nests on Reflectance Confocal Microscopy

Noninvasive imaging techniques such as Reflectance Confocal Microscopy (RCM) have recently been used to investigate microscopic features of melanoma to assess its morphology and for prognostic factors. Among the morphologic features identified in melanoma, cerebriform nests represent a distinctive confocal pattern characterized by multilobulated dermal cell aggregates with convoluted, brain-like contours and heterogeneous reflectivity. The aim of this review is to describe current evidence on the morphological definition, histopathological and molecular correlations, and potential diagnostic and prognostic significance of cerebriform nests in melanoma,as identified by RCM. We included studies conducted on human subjects with diagnosis of melanoma. Cerebriform nests' multilobulated architecture reflects a high degree of structural and biological disorganization of the neoplasm, correlated with histopathological parameters of aggressiveness, such as greater dermal depth, vertical growth, high Clark level, and lymphovascular invasion. In the near future, the identification of cerebriform nests using RCM could contribute not only to improving diagnostic accuracy, but also to prognostic stratification and the selection of patients who may be candidates for personalized treatment pathways.

Abstract from PubMed