Reflected light microscopy, radial streaming

Author: Prof. Dr. med. Peter Altmeyer

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Last updated on: 29.10.2020

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Synonym(s)

Digitiform offshoots; peripheral stripes; radial extensions

Definition
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Reflected light microscopic phenomenon of stripe-shaped extensions in the periphery of a pigmented skin lesion.

General information
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Reflected light microscopy: Radially arranged, finger-shaped, brown-black melanin pigment stripes pointing into the periphery taper at the ends, in contrast to the bulbously widening pseudopodia. At their longitudinal edges the stripes are sometimes finely serrated.

Occurrence
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Within the group of pigment cell tumors, the characteristic of "radial streaming" has a specificity of more than 90% for malignant melanomas (sensitivity about 15%). Spindle cell nevi ( Naevus Spitz) and pigmented basal cell carcinomas may show this phenomenon, rarely junctional nevi and highly pigmented Verrucae seborrhoicae.

Histology
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Radial-striar confluent junctional melanocyte nests with massive transepidermal stripe-like pigment discharge.

Literature
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  1. Bahmer FA, Fritsch P et al (1990) Diagnostic criteria in reflected light microscopy. Dermatologist 41: 513-514
  2. Bauer J et al (2001) Dermatoscopy turns histopathologist's attention to the suspicious area in melanocytic lesions. Arch Dermatol 137: 1338-1340
  3. Haas N, Ernst TM, Stüttgen G (1984) Macro photography in transmitted light. A contribution to the horizontal structural analysis of pigmented skin tumors. Z Hautkr 59: 985-989
  4. Kenet RO, Kang S, Kenet BJ, Fitzpatrick TB, Sober AJ, Barnhill RL (1993) Clinical diagnosis of pigmented lesions using digital epiluminescence microscopy. Arch Dermatol 129: 157-174
  5. Nilles M, Boedecker RH, Schill WB (1994) Surface microscopy of naevi and melanomas - clues to melanoma. Br J Dermatol 130: 349-355
  6. Robinson JK et al (2004) Digital epiluminescence microscopy monitoring of high-risk patients. Arch Dermatol 140: 49-56

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Last updated on: 29.10.2020