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Difference between revisions of "Basal cell carcinoma"
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Image:Basal_cell_carcinoma_fibroepitheliomatous_pattern_-_very_low_mag.jpg | Fibroepithelioma of Pinkus. (WC/Nephron) | Image:Basal_cell_carcinoma_fibroepitheliomatous_pattern_-_very_low_mag.jpg | Fibroepithelioma of Pinkus. (WC/Nephron) | ||
Image:SkinTumors-P6040209.JPG | Fibroepithelioma of Pinkus. (WC) | Image:SkinTumors-P6040209.JPG | Fibroepithelioma of Pinkus. (WC) | ||
Fiboepithelioma of Pinkus 10x 4.tif | Fiboepithelioma of Pinkus 10x 4.tif (MLA) | |||
Fiboepithelioma of Pinkus 10x 3.tif | Fiboepithelioma of Pinkus 10x 3.tif (MLA) | |||
Fiboepithelioma of Pinkus 10x 2.tif | Fiboepithelioma of Pinkus 10x 2.tif (MLA) | |||
Fiboepithelioma of Pinkus 10x.tif | Fiboepithelioma of Pinkus 10x.tif (MLA) | |||
Fibro of pinkus.tif | Fiboepithelioma of Pinkus 4x.tif (MLA) | |||
</gallery> | </gallery> | ||
[[File: 5 41110532329262 sl 1.png|Basal cell carcinoma with mucin production]] | |||
[[File: 5 41110532329262 sl 2.png|Basal cell carcinoma with mucin production]] | |||
[[File: 5 41110532329262 sl 3.png|Basal cell carcinoma with mucin production]] | |||
Basal cell carcinoma with mucin production in the left nasal bridge of a 59 year old man, presenting as a presumptive lacrimal cyst. Because of the location, immunohistochemical stains were needed to exclude eccrine tumors and salivary gland type tumors. A. A spheroidal, well circumscribed mass shows intertwining nests (green arrow), isles with cribriforming (yellow arrows), and large acini (cyan arrows), with good circumscription. B. Round to ovoid nuclei show > 4:1 nuclear size variation in some adjacent pairs (black arrows) and occasional pyknotic nuclei (green arrows). Lumens show mucinous material with vacuoles (yellow arrows); the color argues against adenoid cystic carcinoma, but certainty in that respect could not be maintained without immunostains. Note lining up of nuclei suggestive of palisades (blue arrows). C. Nuclei are P63 positive, not shown are the negative stains for SOX10, CK7, and CD117. | |||
www: | www: | ||
*[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/basal_cell_carcinoma_high_power.jpg BCC (ucsf.edu)].<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/basal_cell_carcinoma.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/basal_cell_carcinoma.html]. Accessed on: 4 September 2011.</ref> | *[http://missinglink.ucsf.edu/lm/DermatologyGlossary/img/Dermatology%20Glossary/Glossary%20Histo%20Images/basal_cell_carcinoma_high_power.jpg BCC (ucsf.edu)].<ref>URL: [http://missinglink.ucsf.edu/lm/DermatologyGlossary/basal_cell_carcinoma.html http://missinglink.ucsf.edu/lm/DermatologyGlossary/basal_cell_carcinoma.html]. Accessed on: 4 September 2011.</ref> | ||
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*[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=930934558 BCC with fibroepitheliomatous pattern (dermatlas.med.jhmi.edu)]. | *[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=930934558 BCC with fibroepitheliomatous pattern (dermatlas.med.jhmi.edu)]. | ||
*[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157603/figure/Fig2/ BCC in vitiligo (nih.gov)].<ref name=pmid20623309>{{Cite journal | last1 = Rustemeyer | first1 = J. | last2 = Günther | first2 = L. | last3 = Deichert | first3 = L. | title = A rare association: basal cell carcinoma in a vitiliginous macula. | journal = Oral Maxillofac Surg | volume = 15 | issue = 3 | pages = 175-7 | month = Sep | year = 2011 | doi = 10.1007/s10006-010-0240-y | PMID = 20623309 }}</ref> | *[http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3157603/figure/Fig2/ BCC in vitiligo (nih.gov)].<ref name=pmid20623309>{{Cite journal | last1 = Rustemeyer | first1 = J. | last2 = Günther | first2 = L. | last3 = Deichert | first3 = L. | title = A rare association: basal cell carcinoma in a vitiliginous macula. | journal = Oral Maxillofac Surg | volume = 15 | issue = 3 | pages = 175-7 | month = Sep | year = 2011 | doi = 10.1007/s10006-010-0240-y | PMID = 20623309 }}</ref> | ||
*[https://dermpath.wordpress.com/category/malignant-cutaneous-neoplasms/basal-cell-carcinoma/ Clear cell BCC (dermpath.wordpress.com)]. | |||
===Basal cell carcinoma subtypes/unique features=== | ===Basal cell carcinoma subtypes/unique features=== | ||
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|- | |- | ||
| Adenoidal pattern | | Adenoidal pattern | ||
| cribriform / pseudoglandular arch. | | [[cribriform]] / pseudoglandular arch. | ||
| myxoid stroma, peripheral palisading | | myxoid stroma, peripheral palisading | ||
| DDx: [[adenoid cystic carcinoma]] | | DDx: [[adenoid cystic carcinoma]] | ||
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==IHC== | ==IHC== | ||
*Ber-EP4 +ve -- typically weak and focal staining. | *[[Ber-EP4]] +ve -- typically weak and focal staining. | ||
**[[Microcystic adnexal carcinoma]] negative.<ref name=pmid23398472 >{{Cite journal | last1 = Sellheyer | first1 = K. | last2 = Nelson | first2 = P. | last3 = Kutzner | first3 = H. | last4 = Patel | first4 = RM. | title = The immunohistochemical differential diagnosis of microcystic adnexal carcinoma, desmoplastic trichoepithelioma and morpheaform basal cell carcinoma using BerEP4 and stem cell markers. | journal = J Cutan Pathol | volume = 40 | issue = 4 | pages = 363-70 | month = Apr | year = 2013 | doi = 10.1111/cup.12085 | PMID = 23398472 }}</ref> | **[[Microcystic adnexal carcinoma]] negative.<ref name=pmid23398472 >{{Cite journal | last1 = Sellheyer | first1 = K. | last2 = Nelson | first2 = P. | last3 = Kutzner | first3 = H. | last4 = Patel | first4 = RM. | title = The immunohistochemical differential diagnosis of microcystic adnexal carcinoma, desmoplastic trichoepithelioma and morpheaform basal cell carcinoma using BerEP4 and stem cell markers. | journal = J Cutan Pathol | volume = 40 | issue = 4 | pages = 363-70 | month = Apr | year = 2013 | doi = 10.1111/cup.12085 | PMID = 23398472 }}</ref> | ||
*CK5/6 +ve. | *CK5/6 +ve (52 of 52<ref name=pmid18496426/>). | ||
**Useful to assess [[margins]]... if very close. | **Useful to assess [[margins]]... if very close. | ||
*CK7 +ve (30 +ve of 52 cases<ref name=pmid18496426>{{cite journal |authors=Alessi E, Venegoni L, Fanoni D, Berti E |title=Cytokeratin profile in basal cell carcinoma |journal=Am J Dermatopathol |volume=30 |issue=3 |pages=249–55 |date=June 2008 |pmid=18496426 |doi=10.1097/DAD.0b013e31816c828a |url=}}</ref>). | |||
*CK19 -ve/+ve (14 +ve 52<ref name=pmid18496426/>). | |||
*CD10 +ve. | *CD10 +ve. | ||
*Actin +ve. | *Actin +ve. | ||
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*SMA +ve.<ref>URL: [http://www.ihcworld.com/_newsletter/2004/2004-12_basal_cell_vs_squamous_v1.pdf http://www.ihcworld.com/_newsletter/2004/2004-12_basal_cell_vs_squamous_v1.pdf]. Accessed on: 19 December 2012.</ref> | *SMA +ve.<ref>URL: [http://www.ihcworld.com/_newsletter/2004/2004-12_basal_cell_vs_squamous_v1.pdf http://www.ihcworld.com/_newsletter/2004/2004-12_basal_cell_vs_squamous_v1.pdf]. Accessed on: 19 December 2012.</ref> | ||
**SCC usually negative. | **SCC usually negative. | ||
Other: | |||
*p63 +ve.<ref name=pmid16630179>{{Cite journal | last1 = Bircan | first1 = S. | last2 = Candir | first2 = O. | last3 = Kapucoglu | first3 = N. | last4 = Baspinar | first4 = S. | title = The expression of p63 in basal cell carcinomas and association with histological differentiation. | journal = J Cutan Pathol | volume = 33 | issue = 4 | pages = 293-8 | month = Apr | year = 2006 | doi = 10.1111/j.0303-6987.2006.00436.x | PMID = 16630179 }}</ref> | |||
==Sign-out== | ==Sign-out== | ||
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===Electrodesiccation and curettage=== | ===Electrodesiccation and curettage=== | ||
<pre> | <pre> | ||
SKIN LESION, SHAVE BIOPSY WITH ELECTRODESICCATION AND CURETTAGE (EDC): | Skin, Left Brow, Biopsy with Electrodesiccation and Curettage (EDC): | ||
- BASAL CELL CARCINOMA, margin status assessed clinically during EDC. | |||
</pre> | |||
====Block letters==== | |||
<pre> | |||
SKIN LESION, LEFT FOREARM, SHAVE BIOPSY WITH ELECTRODESICCATION AND CURETTAGE (EDC): | |||
- BASAL CELL CARCINOMA, MARGIN STATUS ASSESSED CLINICALLY DURING EDC. | - BASAL CELL CARCINOMA, MARGIN STATUS ASSESSED CLINICALLY DURING EDC. | ||
- EXTENSIVE SOLAR ELASTOSIS. | - EXTENSIVE SOLAR ELASTOSIS. | ||