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Zorlu Ö, Karabağ S, Erdoğan KE, Aksın M, Üstün B. Immunoexpression Patterns of Adhesion Molecules (E-cadherin, β-catenin, CD56) and Cytokeratins (CK19, CK20, HMWCK, CAM5.2) During Hair Development in Human Fetuses Compared With Adults. Am J Dermatopathol 2024:00000372-990000000-00358. [PMID: 38842366 DOI: 10.1097/dad.0000000000002741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2024]
Abstract
ABSTRACT Abnormalities in the expression of cytokeratins or adhesion molecules have been associated with hair disorders. The expression patterns of these molecules in the hair follicles of developing human fetuses are not obvious. We aimed to investigate the expression patterns of some cytokeratins and adhesion molecules in the hair follicle of human fetuses and compared them with adults. Forty-eight fetuses of >16 gestational weeks and 22 adult cases with total excisions of benign nevi or cysts were enrolled. The skin samples were taken from both the scalp and back of the fetuses. The histopathologically normal skin areas were evaluated in adults. CK19, CK20, CAM5.2, high-molecular-weight cytokeratin, E-cadherin, β-catenin, and CD56 immunohistochemical stainings were performed. In the fetus group, the staining scores declined in the third trimester but elevated and reached the highest level in adults, except for CD56, which did not stain any adult samples. All stainings were mostly observed in the outer root sheath, except CD56 that stained the perifollicular dermal sheath only in fetuses. E-cadherin, β-catenin, and high-molecular-weight cytokeratin strongly and diffusely stained all adult samples. CAM5.2 and CK19 scores were correlated in fetuses (scalp scores: rs = 0.405, P = 0.004; back scores: rs = 0.422, P = 0.003) and adults (back scores: rs = 0.562, P = 0.046). CD56 negativity indicated the immune-privilege feature of adult hair follicles. As CK19, CAM5.2 may be used to find the regions of stem cells or transient amplifying cells.
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Affiliation(s)
- Özge Zorlu
- Department of Dermatology and Venereology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Sevil Karabağ
- Department of Pathology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
| | - Kıvılcım E Erdoğan
- Department of Pathology, Çukurova University Faculty of Medicine, Adana, Turkey
| | - Merve Aksın
- Department of Pathology, Çukurova University Faculty of Medicine, Adana, Turkey; and
| | - Batuhan Üstün
- Department of Obstetrics and Gynecology, Tekirdağ Namık Kemal University Faculty of Medicine, Tekirdağ, Turkey
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2
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Rybski KJ, Zengin HB, Smoller BR. TRPS1: A Marker of Follicular Differentiation. Dermatopathology (Basel) 2023; 10:173-183. [PMID: 37366800 DOI: 10.3390/dermatopathology10020025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Revised: 06/05/2023] [Accepted: 06/12/2023] [Indexed: 06/28/2023] Open
Abstract
The trichorhinophalangeal syndrome type 1 (TRPS1) immunohistochemical (IHC) stain has increased in use in recent years as a marker for breast carcinomas. The TRPS1 gene is involved in various tissues, including the growth and differentiation of hair follicles. This article seeks to evaluate the IHC expression of TRPS1 in cutaneous neoplasms with follicular differentiation, such as trichoblastoma (TB), trichoepithelioma (TE), and basal cell carcinoma (BCC). IHC studies were performed on 13 TBs, 15 TEs, and 15 BCCs with an antibody against TRPS1. The study found a variable staining expression of TRPS1 in the tumor nests of TB, TE, and BCC. BCCs were distinct in that none of the BCCs demonstrated intermediate or high positivity, while TBs and TEs showed intermediate-to-high positivity in 5/13 (38%) and 3/15 (20%) of cases, respectively. We observed a distinct staining pattern among the mesenchymal cells of TB and TE. We found that TRPS1 highlighted perifollicular mesenchymal cells adjacent to the nests of TB and TE tumor cells. This staining pattern was absent in BCCs, where only scattered stromal cells were positive for TRPS1. Papillary mesenchymal bodies were also highlighted by TRPS1 in TB and TE. TRPS1 stained various parts of the normal hair follicle, including the nuclei of cells in the germinal matrix, outer root sheaths, and hair papillae. TRPS1 may be a useful IHC marker for follicular differentiation.
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Affiliation(s)
- Kristin J Rybski
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Hatice B Zengin
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Bruce R Smoller
- Department of Pathology and Laboratory Medicine, University of Rochester Medical Center, Rochester, NY 14642, USA
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3
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Abalaka SE, Thomas BA, Audu Z, Ejeh SA, Sani NA, Tenuche OZ, Idoko IS, Saleh A, Ubah SA. A case of racemiform trichoblastoma in a dog. J Immunoassay Immunochem 2023; 44:90-102. [PMID: 36318021 DOI: 10.1080/15321819.2022.2137809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Trichoblastoma, which is common in dogs, is now occurring with other cellular changes outside the recognized forms to warrant their continuous evaluation for proper elucidation even as their causes largely remain unknown. A case at hand involved a 9-year-old Caucasian dog, which weighed 35 kg with chief complaint of a progressive bleeding mass on the scalp. The dog had an up-to-date vaccination record and all vital parameters were within optimum ranges. The surgical excision of the firm, solitary, and alopecic mass with traumatized upper surface revealed the presence of a well-demarcated and unencapsulated mass composed of grapes-like nests of basaloid epithelial cells within follicular stroma devoid of stromal necrosis, inflammatory cellular infiltration, and neoplastic epidermal connection. However, there was tissue necrosis, hemorrhages, and inflammatory cellular infiltrates on the exposed upper part of the traumatized growth. Immunohistochemical analysis showed positive reactivity to AE1/AE3, CK5/6, and p63 but negative immunoreactivity to CK7, CK20, CEA, and TTF-1. The histomorphological and immunohistochemical evaluation of the mass on the scalp of the dog suggested a solitary racemiform trichoblastoma with a traumatized exposed upper part despite basal cell carcinoma mimicry where histological diagnosis currently hold sway over immunohistochemical evaluation.
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Affiliation(s)
| | | | - Zakariya Audu
- Department of Animal Health and Production, University of Abuja, Abuja, Nigeria
| | - Sunday Augustine Ejeh
- Department of Veterinary Physiology and Biochemistry, University of Abuja, Abuja, Nigeria
| | | | | | | | - Ahmadu Saleh
- Department of Veterinary Pathology, Ahmadu Bello University, Zaria, Nigeria
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4
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p53/CK17 Dual Stain Improves Accuracy of Distinction Between Differentiated Vulvar Intraepithelial Neoplasia and Its Mimics. Int J Gynecol Pathol 2021; 41:298-306. [DOI: 10.1097/pgp.0000000000000838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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5
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Völkel C, De Wispelaere N, Weidemann S, Gorbokon N, Lennartz M, Luebke AM, Hube-Magg C, Kluth M, Fraune C, Möller K, Bernreuther C, Lebok P, Clauditz TS, Jacobsen F, Sauter G, Uhlig R, Wilczak W, Steurer S, Minner S, Krech RH, Dum D, Krech T, Marx AH, Simon R, Burandt E, Menz A. Cytokeratin 5 and cytokeratin 6 expressions are unconnected in normal and cancerous tissues and have separate diagnostic implications. Virchows Arch 2021; 480:433-447. [PMID: 34559291 PMCID: PMC8986736 DOI: 10.1007/s00428-021-03204-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2021] [Revised: 09/08/2021] [Accepted: 09/10/2021] [Indexed: 12/13/2022]
Abstract
Cytokeratins (CKs) 5 and 6 are functionally unrelated but often analyzed together using bispecific antibodies in diagnostic immunohistochemistry. To better understand the diagnostic utility of CK5 or CK6 alone, tissue microarrays with > 15,000 samples from 120 different tumor types as well as 608 samples of 76 different normal tissues were analyzed by immunohistochemistry. In normal tissues, both CKs occurred in the squamous epithelium; CK5 dominated in basal and CK6 in suprabasal layers. CK5 (not CK6) stained basal cells in various other organs. Within tumors, both CK5 and CK6 were seen in > 95% of squamous cell carcinomas, but other tumor entities showed different results: CK5 predominated in urothelial carcinoma and mesothelioma, but CK6 in adenocarcinomas. Joint analysis of both CK5 and CK6 obscured the discrimination of epithelioid mesothelioma (100% positive for CK5 alone and for CK5/6) from adenocarcinoma of the lung (12.8% positive for CK5 alone; 23.7% positive for CK5/6). CK5 and CK6 expressions were both linked to high grade, estrogen receptor, and progesterone receptor negativity in breast cancer (p < 0.0001 each), grade/stage progression in urothelial cancer (p < 0.0001), and RAS mutations in colorectal cancer (p < 0.01). Useful diagnostic properties which are commonly attributed to CK5/6 antibodies such as basal cell staining in the prostate, distinction of adenocarcinoma of the lung from squamous cell carcinoma and epithelioid mesothelioma, and identification of basal-type features in urothelial cancer are solely driven by CK5. At least for the purpose of distinguishing thoracic tumors, monospecific CK5 antibodies may be better suited than bispecific CK5/6 antibodies.
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Affiliation(s)
- Cosima Völkel
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Noémi De Wispelaere
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,General, Visceral and Thoracic Surgery Department and Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Sören Weidemann
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Natalia Gorbokon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Maximilian Lennartz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Andreas M Luebke
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Claudia Hube-Magg
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Martina Kluth
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christoph Fraune
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Katharina Möller
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Christian Bernreuther
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Patrick Lebok
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till S Clauditz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Frank Jacobsen
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Guido Sauter
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Ria Uhlig
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Waldemar Wilczak
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Stefan Steurer
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Sarah Minner
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Rainer H Krech
- Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - David Dum
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Till Krech
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,Institute of Pathology, Clinical Center Osnabrueck, Osnabrueck, Germany
| | - Andreas H Marx
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.,Department of Pathology, Academic Hospital Fuerth, Fuerth, Germany
| | - Ronald Simon
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany.
| | - Eike Burandt
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
| | - Anne Menz
- Institute of Pathology, University Medical Center Hamburg-Eppendorf, Martinistr. 52, 20246, Hamburg, Germany
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Abstract
CONTEXT - Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. OBJECTIVE - To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. DATA SOURCES - Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. CONCLUSIONS - In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohistochemistry may provide useful ancillary data in certain cases. Awareness of potential mimics is critical to avoid misdiagnosis and resulting inappropriate management.
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Affiliation(s)
- Lauren M Stanoszek
- From the Departments of Pathology (Drs Stanoszek, Wang, and Harms) and Dermatology (Dr Harms), University of Michigan Medical School, Ann Arbor. Drs Stanoszek and Wang contributed equally
| | - Grace Y Wang
- From the Departments of Pathology (Drs Stanoszek, Wang, and Harms) and Dermatology (Dr Harms), University of Michigan Medical School, Ann Arbor. Drs Stanoszek and Wang contributed equally
| | - Paul W Harms
- From the Departments of Pathology (Drs Stanoszek, Wang, and Harms) and Dermatology (Dr Harms), University of Michigan Medical School, Ann Arbor. Drs Stanoszek and Wang contributed equally
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7
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Ho J, Bhawan J. Folliculosebaceous neoplasms: A review of clinical and histological features. J Dermatol 2017; 44:259-278. [PMID: 28256760 DOI: 10.1111/1346-8138.13773] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2016] [Accepted: 12/21/2016] [Indexed: 01/10/2023]
Abstract
Numerous benign and occasionally malignant tumors arise from the folliculosebaceous apparatus. Confusing terminology, rarity of malignant variants and overlapping histological features can lead to diagnostic uncertainty. This review highlights the clinical and histopathological features that help to classify these entities, as well as the various syndromes associated with certain members of this large family of tumors.
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Affiliation(s)
- Jonathan Ho
- Department of Dermatology and Section of Dermatopathology, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Jag Bhawan
- Department of Dermatology and Section of Dermatopathology, Boston University School of Medicine, Boston, Massachusetts, USA
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8
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Leblebici C, Pasaoglu E, Kelten C, Darakci S, Dursun N. Cytokeratin 17 and Ki-67: Immunohistochemical markers for the differential diagnosis of keratoacanthoma and squamous cell carcinoma. Oncol Lett 2017; 13:2539-2548. [PMID: 28454431 PMCID: PMC5403446 DOI: 10.3892/ol.2017.5793] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Accepted: 11/04/2016] [Indexed: 11/06/2022] Open
Abstract
The clinical and histopathological distinction between keratoacanthoma (KA) and squamous cell carcinoma (SCC) is essential, but frequently difficult to make. The utility of CK17 and Ki-67 expression in distinguishing between KA and SCC was investigated. Immunohistochemical staining patterns for CK17 and Ki-67 were evaluated in 24 KA and 27 SCC cases. The pattern of staining was evaluated as central, peripheral or diffuse, according to the basal/peripheral and suprabasal/central cell staining of tumor lobules. The sensitivity and specificity of the central CK17 staining pattern in the identification of KA were 92 and 70%, respectively. Additionally, the sensitivity and specificity of the diffuse Ki-67 staining pattern in the identification of SCC were 81 and 100%, respectively. The results of the present study suggest that a diffuse Ki-67 staining pattern may be used to diagnose SCC, while a central CK17 staining pattern indicates KA. However, the KA-like SCC cases exhibited mixed patterns, which limits the effectiveness of these markers.
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Affiliation(s)
- Cem Leblebici
- Department of Pathology, Istanbul Education and Research Hospital, Istanbul 34098, Turkey
| | - Esra Pasaoglu
- Department of Pathology, Istanbul Education and Research Hospital, Istanbul 34098, Turkey
| | - Canan Kelten
- Department of Pathology, Istanbul Education and Research Hospital, Istanbul 34098, Turkey
| | - Seher Darakci
- Department of Pathology, Erciyes University, School of Medicine, Kayseri 38039, Turkey
| | - Nevra Dursun
- Department of Pathology, Istanbul Education and Research Hospital, Istanbul 34098, Turkey
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9
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Rodriguez Galarza RM, Shrader SM, Koehler JW, Abarca E. A case of basal cell carcinoma of the nictitating membrane in a dog. Clin Case Rep 2016; 4:1161-1167. [PMID: 27980754 PMCID: PMC5134201 DOI: 10.1002/ccr3.728] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2016] [Revised: 07/23/2016] [Accepted: 09/18/2016] [Indexed: 11/09/2022] Open
Abstract
A case of a basal cell carcinoma (BCC) of the nictitating membrane (NM) in a 9-year-old female spayed dachshund is reported. Computed tomography and resection of the NM followed by cryosurgery was performed. Although uncommon, BCC should be considered as a differential diagnosis for tumors of the NM.
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Affiliation(s)
| | - Stephanie M. Shrader
- Department of Clinical SciencesCollege of Veterinary MedicineAuburn UniversityAuburn, ALUSA
| | - Jennifer W. Koehler
- Department of Clinical SciencesCollege of Veterinary MedicineAuburn UniversityAuburn, ALUSA
| | - Eva Abarca
- Department of Clinical SciencesCollege of Veterinary MedicineAuburn UniversityAuburn, ALUSA
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10
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Goyal A, Solus JF, Chan MP, Doyle LA, Schaffer A, Thakuria M, Horn TD, Duncan LM, Nazarian RM. Cytokeratin 17 is highly sensitive in discriminating cutaneous lymphadenoma (a distinct trichoblastoma variant) from basal cell carcinoma. J Cutan Pathol 2016; 43:422-9. [DOI: 10.1111/cup.12700] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Revised: 07/17/2015] [Accepted: 08/11/2015] [Indexed: 01/22/2023]
Affiliation(s)
- Amrita Goyal
- Dermatopathology Unit; Massachusetts General Hospital; Boston MA USA
- Harvard Medical School; Boston MA USA
| | - Jason F. Solus
- Department of Pathology; Washington University School of Medicine; St. Louis MO USA
| | - May P. Chan
- Department of Pathology; University of Michigan Health System; Ann Arbor MI USA
| | - Leona A. Doyle
- Brigham and Women's Hospital; Boston MA USA
- Harvard Medical School; Boston MA USA
| | - Andras Schaffer
- Department of Pathology; Washington University School of Medicine; St. Louis MO USA
| | - Manisha Thakuria
- Brigham and Women's Hospital; Boston MA USA
- Harvard Medical School; Boston MA USA
| | - Thomas D. Horn
- Dermatopathology Unit; Massachusetts General Hospital; Boston MA USA
- Harvard Medical School; Boston MA USA
| | - Lyn M. Duncan
- Dermatopathology Unit; Massachusetts General Hospital; Boston MA USA
- Harvard Medical School; Boston MA USA
| | - Rosalynn M. Nazarian
- Dermatopathology Unit; Massachusetts General Hospital; Boston MA USA
- Harvard Medical School; Boston MA USA
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11
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Loh SH, Lew BL, Sim WY. Composite Tumor Associating Trichoblastoma and Seborrheic Keratosis. Ann Dermatol 2015; 27:601-4. [PMID: 26512175 PMCID: PMC4622895 DOI: 10.5021/ad.2015.27.5.601] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2014] [Revised: 02/05/2015] [Accepted: 02/18/2015] [Indexed: 11/24/2022] Open
Abstract
Seborrheic keratosis is a common benign epidermal tumor histologically composed of basaloid and squamous cells. It mainly occurs on the face, scalp, and trunk, and presents clinically as a well-circumscribed, brownish to black papule, nodule, or plaque. Trichoblastoma is a relatively rare benign, slow-growing tumor showing differentiation toward the primitive hair follicle. It clinically manifests as a solitary, skin to erythematous colored, well-circumscribed dermal nodule located predominantly on the head and neck with a predilection for the scalp. Histologically, a well-demarcated mass of follicular germinative cells that show various degrees of differentiation, arranged in lobules, sheets, and nests, is located in the dermis or subcutaneous fat layer. We report the case of a 28-year-old female patient with a solitary, 2.0×4.0-cm black plaque with a 0.7-cm skin-colored nodule on the scalp. Histologically, the entire black plaque had prominent hyperkeratosis, acanthosis, and papillomatosis with horn cysts. The central nodule showed well-circumscribed, various-sized dermal tumor lobules without a connection to the overlying epidermis. The lobular aggregation was composed of numerous basaloid epithelial nests and multiple primitive papillary structures with distinct peripheral palisading of nuclei. According to these findings, the scalp lesion was diagnosed as a composite tumor associating trichoblastoma and seborrheic keratosis.
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Affiliation(s)
- Seung-Hee Loh
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Bark-Lynn Lew
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
| | - Woo-Young Sim
- Department of Dermatology, Kyung Hee University College of Medicine, Seoul, Korea
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12
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Pozzobon LD, Glikstein R, Laurie SA, Hanagandi P, Michaud J, Purgina B, Ayroud Y, Wasserman JK. Primary cutaneous adenoid cystic carcinoma with brain metastases: case report and literature review. J Cutan Pathol 2015; 43:137-41. [DOI: 10.1111/cup.12563] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2015] [Revised: 07/28/2015] [Accepted: 08/02/2015] [Indexed: 11/29/2022]
Affiliation(s)
- Laura D Pozzobon
- Division of Anatomical Pathology; The Ottawa Hospital; Ottawa Canada
| | - Rafael Glikstein
- Department of Medical Imaging; The Ottawa Hospital; Ottawa Canada
| | - Scott A Laurie
- Division of Medical Oncology; The Ottawa Hospital Regional Cancer Centre; Ottawa Canada
| | - Prasad Hanagandi
- Department of Medical Imaging; The Ottawa Hospital; Ottawa Canada
| | - Jean Michaud
- Division of Anatomical Pathology; The Ottawa Hospital; Ottawa Canada
| | - Bibianna Purgina
- Division of Anatomical Pathology; The Ottawa Hospital; Ottawa Canada
| | - Yasmin Ayroud
- Division of Anatomical Pathology; The Ottawa Hospital; Ottawa Canada
| | - Jason K Wasserman
- Division of Anatomical Pathology; The Ottawa Hospital; Ottawa Canada
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13
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Ziari K, Behdad B, Mohammadshahi A, Pirasteh HR, Sharifi MD, Dadpay M. Cellular and biological evaluation and diagnostic immunohistochemistry of cytokeratin 15/19 expression in distinguishing cutaneous basal cell carcinoma. Biologicals 2015; 43:181-5. [PMID: 25748637 DOI: 10.1016/j.biologicals.2015.02.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/03/2015] [Accepted: 02/05/2015] [Indexed: 11/19/2022] Open
Abstract
Recent studies have investigated the expression of proliferative markers, but little is known about the expression of cytokeratin 15 and 19 in different histological subtypes of basal cell carcinoma (BCC). We conducted cellular, biological, clinicopathological and immunohistochemical analysis on the manifestations of 8 BCC by hematoxylin and eosin stain (H&E) staining and immunohistochemistry and reviewed relevant literature. Microscopically, the tumor cells were multiple remarkable foci of epidermolytic hyperkeratosis with large pleomorphic nuclei and scant cytoplasm together with peripheral palisading and forming solid nests. Furthermore, the most tumors were composed of highly cellular areas with a homogenous population of round, ovoid and spindle cells, hyperchromatic nuclei, high cellular pleomorphism, high mitotic index and various morphologic patterns. Moreover, the tumors displayed an invasive growth, with positive expression of Cytokeratin 19 (CK19) and negative expression of CK15. Our study revealed that the expression of CK19 was associated with progression and invasion in cases with BCC and immunohistochemistry is indispensable in distinguishing this tumor from other types of cutaneous carcinoma. To our best knowledge, it may be a considerable biomarker to assess invasiveness of cutaneous-surface BCC and to guide clinical management of such tumors.
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Affiliation(s)
- Katayoun Ziari
- Department of Pathology, Be'sat Hospital, AJA University of Medical Sciences, Tehran, Iran
| | - Behnoosh Behdad
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Ali Mohammadshahi
- Department of Emergency Medicine, AJA University of Medical Sciences, Tehran, Iran
| | | | - Mohammad Davood Sharifi
- Department of Emergency Medicine, Imam Reza Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Masoomeh Dadpay
- Department of Pathology, Imam Reza Hospital, AJA University of Medical Sciences, Tehran, Iran.
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14
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Unique basaloid findings during Mohs surgery for basal cell carcinoma: a dermatopathology challenge. Dermatol Surg 2014; 40:1446-9. [PMID: 25393354 DOI: 10.1097/dss.0000000000000184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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15
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Misago N, Satoh T, Narisawa Y. Cornification (Keratinization) in Basal Cell Carcinoma: A Histopathological and Immunohistochemical Study of 16 Cases. J Dermatol 2014; 31:637-50. [PMID: 15492437 DOI: 10.1111/j.1346-8138.2004.tb00570.x] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2003] [Accepted: 03/16/2004] [Indexed: 11/26/2022]
Abstract
The concept of keratotic BCC is obscure and not well-defined. To elucidate the histopathological and immunohistochemical properties of cornification in BCC and to clarify the concept of keratotic BCC, by careful examination of 600 BCC specimens, we selected 16 cases of BCC that showed cornification. We investigated the precise histopathological features of these 16 cases, and studied the immunohistochemical expression patterns of anticytokeratin (CK) antibodies (CKs 1, 10, 13, 14, 17) and other antibodies in these cornifying (keratotic) BCCs. We compared these data to those from normal adult hair follicles and three types of cornifying cysts (epidermal cyst, tricholemmal cyst and steatocystoma). Six types of cornification were observed in these BCCs; 1) infundibular type (4 cases) with thin laminated corneocytes expressing CKs 1 and 10, 2) tricholemmal (isthmus) type (9 cases) showing compact, homogenous cornified contents with CK 17 expression on the surrounding cells, 3) inner root sheath type (1 case) characterized by compact, blue-gray corneocytes lined by CK 13 positive-squamous cells with red trichohyalin granules, 4) sebaceous duct type (1 case) characterized by crenulated cornified cells expressing CK 17, 5) apocrine acrosyringium type (2 cases) characterized by small duct-like structures lined by eosinophilic cuticle expressing CEA, in association with keratohyaline granules, and 6) cornifying microcyst type (10 cases) characterized by micro and small cystic structures containing the debris of cornified cells, which was associated with the infundibular or tricholemmal type and could be classified as having the primitive features of the tricholemmal type of cornification. The tricholemmal type could be subdivided into two groups: one with keratohyaline granules and the other without keratohyaline granules, and the cornified contents in approximately 30% of the cornified areas in this type were positive for CK 17. The matrical type of cornification (seventh type) was not seen in our study. The examples described as "keratotic BCC" thus far were similar to BCCs with cornification of the tricholemmal (isthmus) or infundibular type. The cornification in BCCs could be classified into seven types. Excluding the cornifying microcyst type, the tricholemmal type is the most common type of cornification. This type will be abnormal and incomplete in attempts to cornify in the form of an isthmus, occasionally with concomitant exhibition of lower infundibular differentiation. The keratotic BCC is considered to be BCC with cornification of the tricholemmal (isthmus) or infundibular type.
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Affiliation(s)
- Noriyuki Misago
- Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Saga, Japan
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16
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Abstract
This article reviews the recent dermatopathology literature regarding cutaneous adnexal neoplasms, with emphasis on new and underrecognized entities, "old entities" with new findings, advances in immunohistochemistry, and new findings in relation to inherited disorders associated with cutaneous adnexal neoplasms.
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Brachelente C, Porcellato I, Sforna M, Lepri E, Mechelli L, Bongiovanni L. The contribution of stem cells to epidermal and hair follicle tumours in the dog. Vet Dermatol 2013; 24:188-94.e41. [PMID: 23331697 DOI: 10.1111/j.1365-3164.2012.01101.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
BACKGROUND Although cutaneous stem cells have been implicated in skin tumourigenesis in humans, no studies have been conducted to elucidate the presence and the possible role of stem cells in hair follicle tumours in the dog. HYPOTHESIS Stem cell markers are expressed in canine epidermal and follicular tumours and can be used to better understand the biology and origin of these tumours. ANIMALS AND METHODS In the present study, normal skin sections and 44 follicular tumours were retrospectively investigated for the immunohistochemical expression of keratin 15 (K15) and nestin. In addition, 30 squamous cell carcinomas were evaluated for K15 expression. RESULTS In normal skin, K15 and nestin were expressed in the outer root sheath cells of the isthmic portion of the hair follicle (bulge region), and K15 expression was also scattered in the basal cell layer of the epidermis. Infundibular keratinizing acanthomas, pilomatricomas and squamous cell carcinomas were mostly negative for K15, trichoblastomas were moderately to strongly positive, tricholemmomas were either negative or strongly positive, and trichoepitheliomas had heterogeneous staining. Nestin expression was generally faint in all follicular tumours. CONCLUSIONS AND CLINICAL IMPORTANCE Our results show that K15 can be a reliable marker for investigating the role of stem cells in hair follicle tumours of the dog, while nestin was judged to be a nonoptimal marker. Furthermore, our study suggests that hair follicle stem cells are present in the bulge region of hair follicles and could possibly play a role in tumourigenesis of canine tumours originating from this portion of the follicle, namely trichoblastomas, tricholemmomas and trichoepitheliomas. The loss of K15 expression in squamous cell carcinomas compared with normal skin suggests that this event could be important in the malignant transformation.
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Affiliation(s)
- Chiara Brachelente
- Department of Biopathological Sciences and Hygiene of Animal and Alimentary Productions, Faculty of Veterinary Medicine, University of Perugia, Perugia, Italy.
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Trichoblastic sarcoma with osteosarcomatous differentiation: evolution of one lesion with 3 histologic appearances over a 3-year period. Am J Dermatopathol 2013; 34:658-62. [PMID: 22688391 DOI: 10.1097/dad.0b013e3182491d52] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Only one description of trichoblastic sarcoma exists in the literature. Here, we present the first case of trichoblastic sarcoma with heterologous osteosarcomatous differentiation. Biospy 1 demonstrated an intermediate-grade trichoblastic sarcoma with pleomorphic cells and atypical mitotic figures observed only in the stroma. The epithelium contained no malignant cells. The histologic morphology was reminiscent of an intermediate-grade phyllodes tumor of the breast. Biopsy 2, an excisional biopsy taken 7 months later, showed a high-grade sarcoma with osteosarcomatous differentiation. Immunohistochemistry performed on both specimens showed positive CD10 and bcl-2 staining in the sarcomatous component; p63 was positive in the benign epithelium only. p53 was negative in both the benign epithelium and the malignant stroma. Ki-67 labeling was approximately 10% in both components. Specimen 3, a complete rhinectomy performed 3 months later, showed a poorly differentiated sarcoma. Six months following his rhinectomy procedure, multiple pulmonary nodules consistent with metastatic disease were detected on chest computed tomography. This is the first case report documenting the evolution of an intermediate-grade trichoblastic sarcoma to a high-grade lesion with osteosarcomatous differentiation, to a poorly differentiated sarcoma. The tumor morphologically resembles malignant phyllodes tumor of the breast. Our case is the first to show negative p53 and positive bcl-2 staining in a trichoblastic sarcoma. We propose that cutaneous trichoblastic sarcoma is pathogenetically analogous to phyllodes tumors of the breast, adenosarcoma of the uterus, or ameloblastoma of the oral cavity.
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Saridomichelakis MN, Day MJ, Apostolidis KN, Tsioli V, Athanasiou LV, Koutinas AF. Basal cell carcinoma in a dog with chronic solar dermatitis. J Small Anim Pract 2013; 54:108-11. [PMID: 23373837 DOI: 10.1111/j.1748-5827.2012.01302.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
A seven-year-old, entire male, American Staffordshire bull terrier was diagnosed with chronic solar dermatitis and basal cell carcinoma, based on physical examination, cutaneous cytology and histopathology. Immunohistochemistry revealed that the tumour cells did not express p53. To the authors' knowledge this is the first reported case of canine basal cell carcinoma developing as a complication of chronic solar dermatitis.
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Affiliation(s)
- M N Saridomichelakis
- Faculty of Veterinary Medicine, University of Thessaly, Trikalon Str 224, GR-43100, Karditsa, Greece
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20
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Diagnostic utility of immunohistochemistry in distinguishing trichoepithelioma and basal cell carcinoma: evaluation using tissue microarray samples. Mod Pathol 2012; 25:1345-53. [PMID: 22684216 DOI: 10.1038/modpathol.2012.96] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Trichoepithelioma is a benign neoplasm that shares both clinical and histological features with basal cell carcinoma. It is important to distinguish these neoplasms because they require different clinical behavior and therapeutic planning. Many studies have addressed the use of immunohistochemistry to improve the differential diagnosis of these tumors. These studies present conflicting results when addressing the same markers, probably owing to the small number of basaloid tumors that comprised their studies, which generally did not exceed 50 cases. We built a tissue microarray with 162 trichoepithelioma and 328 basal cell carcinoma biopsies and tested a panel of immune markers composed of CD34, CD10, epithelial membrane antigen, Bcl-2, cytokeratins 15 and 20 and D2-40. The results were analyzed using multiple linear and logistic regression models. This analysis revealed a model that could differentiate trichoepithelioma from basal cell carcinoma in 36% of the cases. The panel of immunohistochemical markers required to differentiate between these tumors was composed of CD10, cytokeratin 15, cytokeratin 20 and D2-40. The results obtained in this work were generated from a large number of biopsies and resulted in the confirmation of overlapping epithelial and stromal immunohistochemical profiles from these basaloid tumors. The results also corroborate the point of view that trichoepithelioma and basal cell carcinoma tumors represent two different points in the differentiation of a single cell type. Despite the use of panels of immune markers, histopathological criteria associated with clinical data certainly remain the best guideline for the differential diagnosis of trichoepithelioma and basal cell carcinoma.
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Abstract
Trichoblastic fibroma (TBF), also known as trichoblastoma, small nodular type, is a rare benign cutaneous adnexal tumor that shows trichogenic (follicular) differentiation that can be mistaken clinically and histologically for basal cell carcinoma (BCC), a locally aggressive trichogenic carcinoma. As the clinical behaviors of these two follicular neoplasms are opposite from one another and their management is thus different, recognition of TBF is crucial for effective therapy. Although TBF most commonly is first seen on the face, this lesion has not previously been reported in the eyelid. In this report, we document the first case of TBF affecting the ocular adnexa and detail the histologic features that differentiate TBF from BCC.
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Sellheyer K. Basal cell carcinoma: cell of origin, cancer stem cell hypothesis and stem cell markers. Br J Dermatol 2011; 164:696-711. [PMID: 21128907 DOI: 10.1111/j.1365-2133.2010.10158.x] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Cancer stem cells have recently been described in several high-grade neoplasms. It is still unclear if they also occur in cutaneous malignancies. Cancer stem cells are not identical with somatic stem cells. The presence of tumour stem cells in a neoplasm does not in itself equal that the tumour derives from a somatic stem cell. A cell originally lacking stem cell characteristics could also acquire those features during the course of carcinogenesis and then becomes the clonal founder cell of a tumour. Basal cell carcinoma (BCC) is the most common cutaneous malignancy. A plethora of various stem cell markers has been applied to study its cellular origin. Intriguingly, the anatomical origin of BCC is still uncertain. This review will discuss the various stem cell markers used in BCC and the cellular origin of this tumour, and touches briefly on the possibility of cancer stem cells in BCC. If BCC or other skin cancers harbour tumour stem cells, these cells could be specifically targeted, making use of specific cell surface molecules such as receptor proteins. Novel drugs directed against those receptor proteins could replace currently available shotgun approaches including imiquimod.
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Affiliation(s)
- K Sellheyer
- Department of Dermatology, Cleveland Clinic Foundation, Cleveland, OH 44195, USA.
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23
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Kurokawa I, Takahashi K, Moll I, Moll R. Expression of keratins in cutaneous epithelial tumors and related disorders - distribution and clinical significance. Exp Dermatol 2011; 20:217-28. [DOI: 10.1111/j.1600-0625.2009.01006.x] [Citation(s) in RCA: 49] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
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24
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Hida T, Saga K, Kimura T. Cytokeratin expression patterns in multiple infundibulocystic basal cell carcinoma. J Cutan Pathol 2011; 38:309-13. [DOI: 10.1111/j.1600-0560.2009.01451.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Immunolabeling Pattern of Podoplanin (D2-40) May Distinguish Basal Cell Carcinomas From Trichoepitheliomas: A Clinicopathologic and Immunohistochemical Study of 49 Cases. Am J Dermatopathol 2010; 32:683-7. [DOI: 10.1097/dad.0b013e3181cf8fb4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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26
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Lee HY, Na YR, Seok SH, Baek MW, Kim DJ, Park SH, Lee HK, Lee BH, Park JH. Spontaneous basal cell carcinoma in a 7-week-old Sprague-Dawley rat. Vet Pathol 2010; 47:137-9. [PMID: 20080494 DOI: 10.1177/0300985809353311] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Spontaneous basal cell carcinoma (BCC) is very rare in rats, with an incidence rate of only 0.14% reported in aged animals. A spontaneous BCC occurred in a 7-week-old Sprague-Dawley rat housed in a specific-pathogen-free animal facility. The tumor was a single, well-delineated reddish-brown subcutaneous mass measuring 2 x 2 cm and located in the left inguinal region. Microscopically, the tumor consisted of basaloid cells in lobular and cribriform growth patterns and with a high mitotic rate. Immunohistochemically, cytokeratin 14 (an indicator for basal keratinocytes of the epidermis) showed strong reactions throughout the whole tumor, and cytokeratin 18 showed weak but positive reaction in the majority of nested tumor cells. To the authors' knowledge, this is the first report of spontaneous BCC occurrence in young Sprague-Dawley rats.
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Affiliation(s)
- H-Y Lee
- Department of Laboratory Animal Medicine, College of Veterinary Medicine and KRF Zoonotic Disease Priority Research Institute, Seoul National University, Seoul, Republic of Korea
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27
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Peripheral ameloblastoma in-situ: an evidential fact of surface epithelium origin. ACTA ACUST UNITED AC 2009; 108:763-7. [DOI: 10.1016/j.tripleo.2009.06.018] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2009] [Revised: 06/19/2009] [Accepted: 06/26/2009] [Indexed: 11/18/2022]
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28
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Battistella M, Peltre B, Cribier B. Composite tumors associating trichoblastoma and benign epidermal/follicular neoplasm: another proof of the follicular nature of inverted follicular keratosis. J Cutan Pathol 2009; 37:1057-63. [DOI: 10.1111/j.1600-0560.2009.01341.x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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29
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Gököz O, Presenti L, Gambacorta G, Zolfanelli F, Tricarico R, Nistri R, Baroni G, Bianchi S, Massi D. Skin-type adnexal tumor with trichoblastic germinative differentiation in the breast: a case report. Int J Surg Pathol 2009; 19:527-33. [PMID: 19468034 DOI: 10.1177/1066896909337383] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Adnexal tumors with follicular differentiation in the breast parenchyma are rarely encountered. The authors present a unique case arising in a 64-year-old woman, in whom they observed composite differentiation toward follicular germinative cells of the hair follicle with focal areas of outer root sheath differentiation and pilar-type keratinization. The histogenesis of this tumor is analyzed in light of the peculiar pathological, immunohistochemical, and molecular genetic findings.
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Affiliation(s)
- Ozay Gököz
- Department of Pathology, Hacettepe University Faculty of Medicine, Sihhiye, Ankara, Turkey
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30
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Gu LH, Coulombe PA. Hedgehog signaling, keratin 6 induction, and sebaceous gland morphogenesis: implications for pachyonychia congenita and related conditions. THE AMERICAN JOURNAL OF PATHOLOGY 2008; 173:752-61. [PMID: 18688029 DOI: 10.2353/ajpath.2008.071089] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Keratins 6a and b (K6a, K6b) belong to a subset of keratin genes with constitutive expression in epithelial appendages, and inducible expression in additional epithelia, when subjected to environmental challenges or disease. Mutations in K6a or K6b cause a broad spectrum of epithelial lesions that differentially affect nail, hair, and glands in humans. Some lesions reflect a loss of the structural support function shared by K6, other keratins, and intermediate filament proteins. The formation of sebaceous gland-derived epithelial cysts does not fit this paradigm, raising the question of the unique functions of different K6 isoforms in this setting. Here, we exploit a mouse model of constitutively expressed Gli2, a Hedgehog (Hh) signal effector, to show that K6a expression correlates with duct fate in sebaceous glands (SGs). Whether in the setting of Gli2 transgenic mice skin, which develops a prominent SG duct and additional pairs of highly branched SGs, or in wild-type mouse skin, K6a expression consistently coincides with Hh signaling in ductal tissue. Gli2 expression modestly transactivates a K6a promoter-driven reporter in heterologous systems. Our findings thus identify K6 as a marker of duct fate in SGs, partly in response to Hh signaling, with implications for the pathological expansion of SGs that arises in the context of certain keratin-based diseases and related disorders.
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Affiliation(s)
- Li-Hong Gu
- Department of Biological Chemistry, Johns Hopkins University School of Medicine, 725 N. Wolfe St., Baltimore, MD 21205, USA
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31
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Brasanac D, Boricic I, Todorovic V, Tomanovic N. Primary cutaneous carcinosarcoma: case report with expanded immunohistochemical analysis. Int J Dermatol 2008; 47:496-501. [DOI: 10.1111/j.1365-4632.2008.03427.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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32
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Vidal VPI, Ortonne N, Schedl A. SOX9 expression is a general marker of basal cell carcinoma and adnexal-related neoplasms. J Cutan Pathol 2008; 35:373-9. [PMID: 18333897 DOI: 10.1111/j.1600-0560.2007.00815.x] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND SOX9 is a transcription factor that fulfills multiple functions during development. In the hair follicle SOX9 is expressed in the outer layer of the epithelial sheath, and the hair stem cell compartment. Recent data suggest that Sox9 acts as a downstream target of the Sonic hedgehog (Shh) pathway. Activation of the Shh pathway is a major cause of cutaneous basal cell carcinoma (BCC). Here we test whether activation of SOX9 is a general feature of BCC, or whether it could be used as a biomarker to better define subtypes of these skin tumors. In addition we investigated SOX9 expression in other skin epidermal tumors. METHODS Tumors sections were stained with hematoxylin & eosin (H&E). SOX9 activation was determined by immunofluorescence. RESULTS SOX9 activation was observed in all subtypes of BCC tested. Staining was heterogeneous and could be detected among the basaloid cells of the palisading cell layer as well as in the tumour nest. SOX9 expression was detected in all adnexal tumors analyzed and absent in Bowen's disease and Merkel tumor. CONCLUSIONS SOX9 expression is a general feature of BCC and adnexal skin neoplasms, suggesting a contribution of SOX9 to the pathogenesis of these tumors.
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Abstract
Even though immunohistochemical comparisons of microcystic adnexal carcinoma vs infiltrative basal cell carcinoma and desmoplastic trichoepithelioma exist, they are mostly restricted to the use of a single stain. In addition, a comparison with squamous cell carcinoma has not been reported previously. In this study, we compare the expression of cytokeratin (CK) 15, CK7, CK20, CK903, carcinoembryonic antigen (CEA), CD10, CD15 and BerEP4 in 13 microcystic adnexal carcinoma, eight desmoplastic trichoepithelioma, 10 infiltrative basal cell carcinoma, and eight squamous cell carcinoma of which five exhibited ductal differentiation. We found that the majority of microcystic adnexal carcinoma (92%) and desmoplastic trichoepithelioma (100%) cases expressed CK15 while the infiltrative basal cell carcinoma and squamous cell carcinoma cases were all negative. Forty percent of infiltrative basal cell carcinoma expressed CK7; while only two microcystic adnexal carcinoma cases (15%) and one squamous cell carcinoma with ductal differentiation (12%) expressed CK7 in the remaining three tumor categories. None of the desmoplastic trichoepithelioma expressed CK7. All tumors were strongly positive for CK903. While the neoplastic cells were negative, luminal staining of ductal structures was noted for CK7, CD15 and CEA in some of the microcystic adnexal carcinoma, desmoplastic trichoepithelioma and squamous cell carcinoma with ductal differentiation cases. Sixty percent of infiltrative basal cell carcinoma, 31% of microcystic adnexal carcinoma, and 25% of squamous cell carcinoma express CD10. BerEP4 expression was noted in 38% of microcystic adnexal carcinoma, 57% of desmoplastic trichoepithelioma, 100% of infiltrative basal cell carcinoma, and 38% of squamous cell carcinoma. In conclusion, we found CK15 to be a useful marker in distinguishing microcystic adnexal carcinoma from infiltrative basal cell carcinoma and squamous cell carcinoma with ductal differentiation. Our experience indicates that microcystic adnexal carcinoma and desmoplastic trichoepithelioma have a similar immunohistochemical profile that is, CK15+ and BerEP4+/-; thus, additional studies are needed to separate these two entities.
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Kishino M, Murakami S, Yuki M, Iida S, Ogawa Y, Kogo M, Toyosawa S. A immunohistochemical study of the peripheral ameloblastoma. Oral Dis 2007; 13:575-80. [PMID: 17944675 DOI: 10.1111/j.1601-0825.2006.01340.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- M Kishino
- Department of Oral Pathology, Osaka University Graduate School of Dentistry, Osaka, Japan.
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35
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36
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Sanders D, Carr R. The use of immunohistochemistry in the differential diagnosis of common epithelial tumours of the skin. ACTA ACUST UNITED AC 2007. [DOI: 10.1016/j.cdip.2007.05.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Yamamoto T, Yokozeki H. Persistent bilateral hyperpigmentation caused by local stem cell factor injection. J Eur Acad Dermatol Venereol 2007; 21:576-7. [PMID: 17374016 DOI: 10.1111/j.1468-3083.2006.01976.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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38
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Al-Arashi MYH, Byers HR. Cutaneous clear cell squamous cell carcinoma in situ : clinical, histological and immunohistochemical characterization. J Cutan Pathol 2007; 34:226-33. [PMID: 17302606 DOI: 10.1111/j.1600-0560.2006.00593.x] [Citation(s) in RCA: 31] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Clear cell squamous cell carcinoma in situ (SCCIS) has not been defined in the literature with respect to its clinical, histological, and immunohistochemical features. METHODS Nearly 1500 consecutive cases of SCCIS were assessed for percent clear cell change. The clinical features of all SCCIS with >or=10% clear cell change, including age, sex and site distribution, were compared with classical SCCIS using chi-square analysis. PAS special staining and immunohistochemical analysis with 11 cell markers were performed to characterize the clear cell of origin. RESULTS Eighty SCCIS cases with a spectrum of clear cell change of >or=10% were identified. Six cases with >or=80% clear cells were defined as clear cell SCCIS. The clinical features of the cases did not vary significantly from classical SCCIS. Antibodies labeling outer root sheath (ORS) cells also labeled clear cells in the cases and included K8.12 (labeling CK13 and CK16), cellular retinoic acid binding protein II, CAM 5.2 and CK15. Antibodies that did not label ORS cells, but did label eccrine glands (CK7 and CK18) or sebocytes (EMA), also did not label the cases. CONCLUSION Clear cell change in SCCIS is part of a spectrum which displays ORS differentiation.
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Alsaad KO, Obaidat NA, Ghazarian D. Skin adnexal neoplasms--part 1: an approach to tumours of the pilosebaceous unit. J Clin Pathol 2007; 60:129-44. [PMID: 16882696 PMCID: PMC1860623 DOI: 10.1136/jcp.2006.040337] [Citation(s) in RCA: 100] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/02/2006] [Indexed: 12/16/2022]
Abstract
Skin adnexal neoplasms comprise a wide spectrum of benign and malignant tumours that exhibit morphological differentiation towards one or more types of adnexal structures found in normal skin. Most adnexal neoplasms are relatively uncommonly encountered in routine practice, and pathologists can recognise a limited number of frequently encountered tumours. In this review, the first of two, the normal histology of the skin adnexal structures is reviewed, and the histological features of selected but important benign and malignant tumours and tumour-like lesions of pilosebaceous origin discussed, with emphasis on the diagnostic approach and pitfalls in histological diagnosis.
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Affiliation(s)
- K O Alsaad
- Department of Laboratory Medicine and Pathobiology, University of Toronto and University Health Network, Toronto, Ontario, Canada
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Pham TTN, Selim MA, Burchette JL, Madden J, Turner J, Herman C. CD10 expression in trichoepithelioma and basal cell carcinoma. J Cutan Pathol 2006; 33:123-8. [PMID: 16420307 DOI: 10.1111/j.0303-6987.2006.00283.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
BACKGROUND Trichoepithelioma (TE) is a benign neoplasm that shares both clinical and histologic features with basal cell carcinoma (BCC). However, it is important to distinguish these neoplasms. Limited immunohistochemical stains are available to separate these two tumors. METHODS CD10 protein immunohistochemistry was performed on paraffin-embedded biopsies of 13 TE and 23 BCC diagnosed by routine microscopy. Cases were analyzed for pattern of CD10 expression by tumor cells and surrounding stroma. RESULTS Twelve of 13 (92%) TE showed positive stromal immunoreactivity. Of these, eight cases also demonstrated positivity of the papilla, and two also showed positivity of the basaloid cells. No TE demonstrated epithelial expression alone. On the other hand, expression of CD10 by basaloid cells was identified in 20 (87%) cases of BCC. Stromal positivity was also identified in three cases of BCC. Condensation of CD10-positive stromal cells around basaloid nests was statistically significant in differentiating TE from BCC (p < 0.0001). Conversely, CD10-positive basaloid cells were seen predominantly in BCC (p < 0.0001). CONCLUSIONS This study demonstrates a statistically significant difference in CD10 staining pattern between TE and BCC. Thus, CD10 may be a useful adjunct marker in distinguishing these tumors.
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Affiliation(s)
- Teresa Tram N Pham
- Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA
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Kurokawa I, Mizutani H, Nishijima S, Kato N, Yasui K, Tsubura A. Trichoadenoma: cytokeratin expression suggesting differentiation towards the follicular infundibulum and follicular bulge regions. Br J Dermatol 2006; 153:1084-6. [PMID: 16225641 DOI: 10.1111/j.1365-2133.2005.06929.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Howell BG, Solish N, Lu C, Watanabe H, Mamelak AJ, Freed I, Wang B, Sauder DN. Microarray profiles of human basal cell carcinoma: Insights into tumor growth and behavior. J Dermatol Sci 2005; 39:39-51. [PMID: 15978418 DOI: 10.1016/j.jdermsci.2005.02.004] [Citation(s) in RCA: 269] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2004] [Revised: 01/31/2005] [Accepted: 02/25/2005] [Indexed: 10/25/2022]
Abstract
PURPOSE Basal cell carcinoma (BCC) is the most common human neoplasm. Much interest lies in determining the genetic basis of BCC to explain the unique locally invasive phenotype and infrequent metastatic behavior of these skin tumors. OBJECTIVE We sought to examine a gene expression profile for BCC to elucidate new molecules responsible for its unique growth characteristics. METHODS We analyzed gene expression patterns of 50 BCC tumors using spotted cDNA microarrays of 1718 characterized human genes related to cancer and immunity. This is the largest and most comprehensive gene expression study ever performed for BCC. Nodular and sclerosing histological subtypes of BCC were examined and compared to normal control skin. After statistical filtering, 374 significantly dysregulated genes were sorted by hierarchical clustering to determine trends of gene expression and similarities between patient gene expression profiles. RESULTS A total of 165 upregulated genes and 115 downregulated genes were identified. These covered a range of categories, including extracellular matrix, cell junctions, motility, metastasis, oncogenes, tumor suppressors, DNA repair, cell cycle, immune regulation and angiogenesis. Clusters of genes were either commonly dysregulated across the 50 patient sample, or selectively affected in subsets of tumors. Histological subtypes were not distinguishable by hierarchical clustering. Many of the genes elucidated, including collagen type IV subunits and other novel candidates, possess functions related to extracellular matrix remodeling and metastasis. CONCLUSION These results suggest a gene profile which may explain the invasive growth yet rarely metastatic behavior of BCC. The genes identified may also be potential targets for therapeutics aimed at further controlling invasiveness and local destruction of BCC.
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Affiliation(s)
- Brandon G Howell
- Department of Dermatology, Johns Hopkins University School of Medicine, Baltimore, MD 21287-0900, USA
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Chu PG, Schwarz RE, Lau SK, Yen Y, Weiss LM. Immunohistochemical staining in the diagnosis of pancreatobiliary and ampulla of Vater adenocarcinoma: application of CDX2, CK17, MUC1, and MUC2. Am J Surg Pathol 2005; 29:359-67. [PMID: 15725805 DOI: 10.1097/01.pas.0000149708.12335.6a] [Citation(s) in RCA: 145] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Pancreatobiliary and ampulla of Vater adenocarcinomas frequently metastasize to regional lymph nodes, liver, or lung and are difficult to diagnose because they lack specific immunohistochemical markers. We studied the expression of cytokeratin 7 (CK7), cytokeratin 17 (CK17), cytokeratin 20 (CK20), CDX2, mucin 1 (MUC1), mucin 2 (MUC2), and mucin 5AC (MUC5AC) in 46 cases of pancreatic ductal carcinoma, 18 ampulla of Vater adenocarcinomas, and 24 intrahepatic cholangiocarcinomas. The expression of MUC1 and CK17 was restricted to pancreatic ductal carcinoma (41 of 46, 89%; 38 of 46, 83%, respectively), the ampullary carcinoma of pancreatobiliary origin (6 of 6, 100%; 5 of 6, 83%, respectively), and intrahepatic cholangiocarcinoma (20 of 24, 83%; 17 of 24, 71%, respectively). More than 50% of cases of pancreatobiliary adenocarcinomas showed diffuse cytoplasmic CK17 positivity. In contrast, less than 5% cases (8 of 184) of extra-pancreatobiliary nonmucinous adenocarcinomas expressed CK17, and only 3 of them showed diffuse CK17 positivity. The expression of MUC2 and CDX2 was restricted to the intestinal, mucinous, and signet-ring cell-type adenocarcinomas of duodenal papillary origin (9 of 11, 82%; 11 of 11, 100%, respectively). MUC2 was rarely expressed in pancreatic ductal carcinoma (1 of 46, 2%) and was negative in the ampullary carcinoma of pancreatobiliary origin and in intrahepatic cholangiocarcinoma. A heterogeneous CDX2 staining pattern was seen in 1 of 6 cases of the ampullary carcinoma of pancreatobiliary origin (17%), 5 of 24 intrahepatic cholangiocarcinomas (21%), and 10 of 46 (22%) pancreatic ductal carcinomas. In contrast, all 11 cases of the intestinal, mucinous, and signet-ring cell-type adenocarcinomas of duodenal papillary origin showed homogeneous CDX2 nuclear positivity. We concluded that CK17 is a useful marker in separating pancreatobiliary adenocarcinomas from extra-pancreatobiliary nonmucinous adenocarcinomas, including adenocarcinomas from the colon, breast, gynecologic organs, stomach, lung, prostate, thyroid, kidney, and adrenal gland, and malignant mesothelioma. MUC1+/CK17+ can be used as positive markers for pancreatic ductal carcinomas, the ampullary carcinoma of pancreatobiliary origin, and cholangiocarcinomas with positive predictive values of 76%, 83%, and 58%, respectively. MUC2+/CDX2+ can be used as positive markers for the intestinal-type adenocarcinoma of duodenal papillary origin with a positive predictive value of 82%.
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Affiliation(s)
- Peiguo G Chu
- Division of Pathology, City of Hope National Medical Center, Duarte, CA 91010, USA.
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Apaydin R, Gürbüz Y, Bayramgürler D, Bilen N. Cytokeratin contents of basal cell carcinoma, epidermis overlying tumour, and associated stromal amyloidosis: an immunohistochemical study. Amyloid 2005; 12:41-7. [PMID: 16076610 DOI: 10.1080/13506120500032543] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Cytokeratins (CKs) are expressed specifically in the cytoplasm of epithelial cells. We investigated the expression of CKs immunohistochemically in basal cell carcinomas (BCCs), epidermis overlying tumour, and skin tumor-associated amyloidosis (STA). Twenty cases of BCC, 11 of which had STA were included to the study. The primary antibodies of CK1-8 (AE3), CK10 (DEK-10), CK14 (LL002), CK17 (E3), CK18 (DC10), CK19 (KS19.1), CK 5/6/18 (LP34), CK8/18 (5D3) were applied to the section immunohistochemically. In BCCs without STA, CK1-8, CK14 and CK17 antibodies were expressed by tumour tissue in all biopsy specimens. In the BCCs with STA, tumour tissue was immunoreactive always with CK1-8 and CK17 antibodies, and commonly immunoreactive with anti-CK 14 antibody. In the epidermis overlying tumour tissue, there was positive immunoreactivity with anti-CK 1-8, CK 5/6/18, CK 10 and CK 14 antibodies in all biopsy specimens. Anti-CK 17 antibody was also positive in 17 biopsy specimens. STA is immunoreactive with anti-CK1-8 in all specimens. There was mild staining with anti-CK5/6/18 and with anti-CK19 whereas no immunoreactivity with anti-CK10 and CK18 antibodies was found. In conclusion, we could not find a significant CK expression difference between BCCs with and without STA. Weak positivity and a few number of CKs were shown in STA when compared with those of BCC and epidermis overlying tumour tissue expressing the more variable CKs. Interestingly, although CKs coexpressed in pairs consisting of one basic and one acidic CK, we detected predominantly basic CKs in STA.
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Affiliation(s)
- Rebiay Apaydin
- Department of Dermatology, Kocaeli University Medical Faculty, Kocaeli, Turkey.
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Abstract
Some authors have used sebaceous epithelioma as a synonym for basal cell carcinoma (BCC) with sebaceous differentiation. However, our review of the literature revealed that definite cases of BCC with sebaceous differentiation that provide adequate clinical and histopathologic information are scarce. We present the case of a 72-year-old woman with a pigmented nodular lesion on her right ala nasi region, clinically diagnosed as pigmented BCC. Histopathologically, this nodular lesion, which was completely excised, showed typical features of BCC. It was noteworthy that within one aggregation of the presented BCC, tiny and small duct-like structures lined by cornified layers with a crenulated inner surface were seen. Vacuolated cells were scattered within a few aggregations, and they had foamy, bubbly cytoplasm and starry nuclei. The vacuolated cells were immunohistochemically positive for epithelial membrane antigen (EMA). These histopathologic findings demonstrated unquestionable sebaceous differentiation in this BCC, namely BCC with sebaceous differentiation, which should be distinguishable from both sebaceoma and sebaceous carcinoma. The small duct-like structures lined by eosinophilic cuticle, indicating apocrine differentiation, were also observed in this BCC.
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Affiliation(s)
- Noriyuki Misago
- Division of Dermatology, Saga Medical School, Nabeshima, Saga,
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Lum CA, Binder SW. Proliferative characterization of basal-cell carcinoma and trichoepithelioma in small biopsy specimens. J Cutan Pathol 2004; 31:550-4. [PMID: 15268710 DOI: 10.1111/j.0303-6987.2004.00230.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
We examined the proliferative characteristics of 20 basal-cell carcinomas (BCCs) and 16 trichoepitheliomas (TEps) in an effort to understand and explore possible differences in their tumorigenic cell-cycle properties. These tumors were first compared for their expression of the nuclear proliferative protein Ki-67 and the tumor suppressor protein p53. We also compared the p53 downstream effector, p21(waf-1/cip-1), an inhibitor of cyclin-dependent kinases. The other p53-dependent, cyclin-dependent kinase inhibitor, p27(kip-1), has shown to be increased in TEps, which is consistent with this benign neoplasm's better-differentiated state. In our findings, we confirmed through immunohistochemical staining for Ki-67 that BCCs qualitatively showed a greater proliferative fraction compared to TEps (50.0 vs. 13.0%, p < 0.00001) as well as over-expression of p53 (2+ vs. 1+, p < 0.0008). BCCs marked by p21 demonstrated scattered nuclear positivity compared to the virtual absence of staining in the TEps (p < 0.019). In studying their cell-cycle properties, our findings suggest that abnormalities in the p53 pathway allow BCCs to obtain a growth advantage. We show that Ki-67 and p53 staining both appear useful in resolving challenging differential diagnoses and thereby help in directing appropriate treatment strategies.
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Affiliation(s)
- Christopher A Lum
- Division of Surgical Pathology, LAC-USC Medical Center, USC-Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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Yamamoto O, Yasuda H. Extramammary Paget's disease with superimposed herpes simplex virus infection: immunohistochemical comparison with cases of the two respective diseases. Br J Dermatol 2003; 148:1258-62. [PMID: 12828759 DOI: 10.1046/j.1365-2133.2003.05355.x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
We describe an extremely rare case of genital Paget's disease with superimposed herpes simplex virus (HSV) infection. We also describe immunohistochemical comparison of this lesion with 19 cases of genital Paget's disease and 12 cases of skin lesions caused by HSV or varicella-zoster virus. The Paget cells expressed simple epithelial keratins (CK7 and CK19) and carcinoembryonic antigen (CEA), but did not express stratified epithelial keratins (CK1, CK2e, CK10, CK5/8, CK14). Conversely, the virus-infected keratinocytes were positive for stratified epithelial keratins but negative for simple epithelial keratins and CEA. In the present case, simple epithelial keratins, stratified epithelial keratins, CEA and HSV were heterogeneously expressed in the ballooning and multinucleated giant cells. These results suggest that these cells were derived from keratinocytes and Paget cells and that the production of many multinucleated giant cells resulted from the virus-mediated cell fusion between Paget cells and neighbouring keratinocytes.
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Affiliation(s)
- O Yamamoto
- Department of Dermatology and Occupational Dermatopathology, School of Medicine, University of Occupational and Environmental Health Japan.
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Misago N, Satoh T, Narisawa Y. Basal cell carcinoma with tricholemmal (at the lower portion) differentiation within seborrheic keratosis. J Cutan Pathol 2003; 30:196-201. [PMID: 12641780 DOI: 10.1034/j.1600-0560.2003.00020.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
BACKGROUND Recent genetic investigations support the idea that basal cell carcinoma (BCC) is trichoblastic carcinoma. However, it is generally thought that clear cell basal cell carcinoma is a result of degeneration rather than tricholemmal differentiation. METHODS We report a case of BCC, with clear cell components, that developed within seborrheic keratosis, with histopathological and immunohistochemical findings. RESULTS The clear cell components in the present case showed the following four characteristics: (i) at the periphery of the aggregations, columnar clear cells were aligned in a palisade along a well-defined basement membrane; (ii) the nuclei of the columnar clear cells were at the pole opposite the basement membrane; (iii) the clear cells contained glycogen; (iv) in the aggregations with clear cell components, there was diffuse positive staining for cytokeratin 7 (CK7) (OV/TLR/30), but only the inner region stained positive for CK17. These four characteristics are comparable to those of the lower portion of normal outer root sheath. In addition, the BCC in the present case was partly composed of squamous cells that contained glycogen and were selectively positive for CK17 - features similar to those of squamous cells in normal outer root sheath. CONCLUSIONS Some clear cell BCCs are simply the result of degenerative change, but other clear cell BCCs may be the result of tricholemmal (at the lower portion) differentiation.
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Affiliation(s)
- Noriyuki Misago
- Division of Dermatology, Department of Internal Medicine, Saga Medical School, Saga, Japan.
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Kanitakis J, Brutzkus A, Butnaru AC, Claudy A. Melanotrichoblastoma: immunohistochemical study of a variant of pigmented trichoblastoma. Am J Dermatopathol 2002; 24:498-501. [PMID: 12454603 DOI: 10.1097/00000372-200212000-00008] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Trichoblastomas (TBs) are benign skin tumors recapitulating the differentiation of hair follicles. Several pathologic variants have been described, including the rare pigmented TB. We report a deeply pigmented nodular tumor excised on the scalp of a 32-year-old African woman, which was clinically suggestive of blue nevus or melanoma. Histologically, the tumor presented features of TB, remarkable by virtue of heavy melanin deposits found within and around tumor nests. By immunohistochemistry, abundant dendritic melanocytes with features of hair follicle melanocytes (expression of S100 protein, tyrosinase, and, most importantly, gp100/HMB-45) were found within the tumor masses. By analogy with melanoacanthoma, a tumor consisting of a combined proliferation of epidermal keratinocytes and melanocytes, we called this tumor "melanotrichoblastoma" and view it as a peculiar variant of (pigmented) TB.
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Affiliation(s)
- Jean Kanitakis
- Depatment of Dermatology, Ed Harriot Hospital, Lyon, France.
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Yamamoto O, Doi Y, Hamada T, Hisaoka M, Sasaguri Y. An immunohistochemical and ultrastructural study of syringocystadenoma papilliferum. Br J Dermatol 2002; 147:936-45. [PMID: 12410704 DOI: 10.1046/j.1365-2133.2002.05027.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Syringocystadenoma papilliferum is a benign hamartomatous tumour of the skin. The histogenesis of this tumour is still controversial. There have been few reports regarding immunohistochemical investigations using only a limited range of antibodies and ultrastructural studies on this rare tumour. OBJECTIVES To elucidate the immunohistochemical and ultrastructural properties of this tumour. METHODS We investigated the immunohistological patterns of 12 different anticytokeratin (CK) antibodies and several other markers in five cases of this tumour, comparing them with the patterns in adult sweat glands. One of these cases was also evaluated ultrastructurally. RESULTS The luminal columnar cells of the tumour were mostly positive for CK7 and more than 70% were positive for CK19. These cells showed the heterogeneous expression of CK1/5/10/14, CK14 and CK5/8. These patterns were also observed in the luminal cells in the secretory or the ductal portion of the adult sweat glands. The basal cuboidal cells of the tumour almost constantly expressed CK1/5/10/14, CK5/8, CK14 and CK7 (except for one case), similar to the patterns of basal cells in the transitional portion and myoepithelial cells in the sweat glands. However, the basal tumour cells expressed CK19 and vimentin heterogeneously, and alpha-smooth muscle actin focally (three cases). Ultrastructurally, the constituent epithelial cells were mainly divided into three types: luminal cells, basal cells and clear cells. The luminal tumour cells bore features of the secretory or ductal luminal cells of sweat glands, although they were somewhat immature in appearance. The basal tumour cells were fundamentally basaloid in nature. The clear cells were undifferentiated or primitive in appearance, suggesting stem or progenitor cell properties. Transitional forms between the clear cells and the other two cell types were also identified. CONCLUSIONS The tumour epithelium was composed of several cell types demonstrating various developmental stages from the primitive clear cells to the basal cells demonstrating a tendency to differentiate toward basal cells in the apocrine transitional portion or myoepithelial lineage, or luminal cells toward the ductal or secretory epithelium. These results support the classical concept that syringocystadenoma papilliferum is a hamartomatous tumour that arises from pluripotent cells.
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Affiliation(s)
- O Yamamoto
- Department of Dermatology, School of Medicine, University of Occupational and Environmental Health Japan, 1-1 Iseigaoka, Yahatanishi-Ku, Kitakyushu 807-8555, Japan.
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