|
1
|
Cocuz IG, Popelea MC, Niculescu R, Manea A, Sabău AH, Tinca AC, Szoke AR, Budin CE, Stoian A, Morariu SH, Cotoi TC, Cocuz ME, Cotoi OS. Pathophysiology, Histopathology, and Differential Diagnostics of Basal Cell Carcinoma and Cutaneous Squamous Cell Carcinoma-An Update from the Pathologist's Point of View. Int J Mol Sci 2024; 25:2220. [PMID: 38396897 PMCID: PMC10888641 DOI: 10.3390/ijms25042220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2024] [Revised: 02/07/2024] [Accepted: 02/11/2024] [Indexed: 02/25/2024] Open
Abstract
Basal cell carcinoma (BCC) and cutaneous squamous cell carcinoma (cSCC) are the most frequently occurring non-melanocytic skin cancers. The objective of our study is to present the pathophysiology of BCC and cSCC and its direct relationship with the histopathological diagnostics and the differential diagnostics of these types of cancer, based on the morphological characteristics, immunohistochemical profile, and genetic alterations. The qualitative study was based on emphasizing the morphological characteristics and immunohistochemistry profiles of BCC and cSCC and the differential diagnostics based on the tissue samples from the Clinical Pathology Department of Mures Clinical County Hospital between 2020 and 2022. We analyzed the histopathological appearances and immunohistochemical profiles of BCC and cSCC in comparison with those of Bowen disease, keratoacanthoma, hyperkeratotic squamous papilloma, metatypical carcinoma, pilomatricoma, trichoblastoma, Merkel cell carcinoma, pleomorphic dermal sarcoma (PDS), and melanoma. Our study showed the importance of the correct histopathological diagnosis, which has a direct impact on the appropriate treatment and outcome for each patient. The study highlighted the histopathological and morphological characteristics of NMSCs and the precursor lesions in HE and the immunohistochemical profile for lesions that may make the differential diagnosis difficult to establish.
Collapse
Affiliation(s)
- Iuliu Gabriel Cocuz
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | | | - Raluca Niculescu
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Andrei Manea
- Faculty of Medicine, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
| | - Adrian-Horațiu Sabău
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Andreea-Cătălina Tinca
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Andreea Raluca Szoke
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Corina Eugenia Budin
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pneumology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Adina Stoian
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Neurology I Clinic, Targu Mures Emergency County Hospital, 540136 Targu Mures, Romania
| | - Silviu Horia Morariu
- Dermatology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
- Dermatology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Titiana Cornelia Cotoi
- Pharmaceutical Technique Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania;
- Pharmacy No. 2, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| | - Maria-Elena Cocuz
- Fundamental Prophylactic and Clinical Disciplines Department, Faculty of Medicine, Transilvania University of Brasov, 500003 Brașov, Romania;
- Clinical Pneumology and Infectious Diseases Hospital of Brasov, 500174 Brasov, Romania
| | - Ovidiu Simion Cotoi
- Pathophysiology Department, “George Emil Palade” University of Medicine, Pharmacy, Sciences and Technology of Targu Mures, 540142 Targu Mures, Romania; (I.G.C.); (R.N.); (A.-H.S.); (A.-C.T.); (A.R.S.); (C.E.B.); (A.S.); (O.S.C.)
- Pathology Department, Mures Clinical County Hospital, 540011 Targu Mures, Romania
| |
Collapse
|
|
2
|
Mayo-Martínez F, Moro R, Traves V, Llombart B, Requena C. Trichoepithelioma on the Finger: A Rare Location and Dermoscopic-Histopathologic Correlation. Am J Dermatopathol 2023; 45:142-144. [PMID: 36669081 DOI: 10.1097/dad.0000000000002333] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
ABSTRACT Trichoepithelioma is a benign adnexal neoplasm of follicular germinative cells, with bulbs, papillae, and sheaths of perifollicular connective tissue as signs of follicular differentiation. Accordingly, trichoepithelioma may arise in any hair-bearing location, mostly on the face. That is why trichoepithelioma cannot appear in glabrous skin, and, although the dorsum of the hands and feet are a hair-bearing area, acral location is exceptional. We report the first case of trichoepithelioma localized in the finger of a 79-year-old man. It was a brown-pink, firm, 7-mm diameter, solid papule on the dorsal aspect of his left index finger. The lesion was completely asymptomatic, and he remembered to have it for many years. We describe this case highlighting its rare anatomical location and correlate its dermoscopic features with the histopathological appearance.
Collapse
Affiliation(s)
| | - Ruggero Moro
- Instituto Dermatológico Dr Alonso, Hospital Vithas Valencia 9 de Octubre, Valencia, Spain; and
| | - Victor Traves
- Departments of Pathology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Beatriz Llombart
- Departments of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| | - Celia Requena
- Departments of Dermatology, Instituto Valenciano de Oncología, Valencia, Spain
| |
Collapse
|
|
3
|
Sławińska M, Płaszczyńska A, Lakomy J, Pastuszak K, Biernat W, Sikorska M, Nowicki RJ, Sobjanek M. Significance of Dermoscopy in Association with Clinical Features in Differentiation of Basal Cell Carcinoma and Benign Trichoblastic Tumours. Cancers (Basel) 2022; 14:cancers14163964. [PMID: 36010957 PMCID: PMC9406107 DOI: 10.3390/cancers14163964] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2022] [Revised: 08/08/2022] [Accepted: 08/10/2022] [Indexed: 11/16/2022] Open
Abstract
Background: Although basal cell carcinoma (BCC) can, in the majority of cases, be diagnosed based on clinical and dermoscopic assessment, a potential overlap with benign adnexal skin tumours seems to exist, including trichoblastic tumours (TT). Methods: Retrospective analysis of clinical and dermoscopic features of benign TT and BCC cases was performed to develop a diagnostic algorithm with a potential utility in clinical practice. Results: In the study, 502 histopathologically confirmed BCC cases were compared with 61 TT (including 44 TB (72.13%), 10 TE (16.39%) and 7 DTE (11.48%]). Patients in the BCC group were statistically older (mean age was 71.4 vs. 64.4 years, respectively; p = 0.009). BCC presented generally as larger tumours (mean tumour size 11.0 vs. 8.2 mm for the TT group; p = 0.001) and was more frequently associated with clinically visible ulceration (59.4% vs. 19.7%, respectively; p < 0.001). Comparison of lesion morphology, clinically visible pigmentation, and anatomical location did not show significant differences between the analysed groups. Dermoscopically visible ulceration was significantly more common in the BCC group compared to the TT group (52.2% vs. 14.8%; p < 0.0001). Pigmented structures, specifically brown dots and brown globules, were significantly more prevalent in the TT group (32.8% vs. 11.4%; p = 0.0001 and 29.5% vs. 8.2%; p <0.0001). Similarly, TT more commonly than BCC showed the presence of cloudy/starry milia-like cysts (26.2% vs. 11.6%; p = 0.0031) and yellow globules (16.4% vs. 7.2%; p = 0.033). Conclusions: Despite differences in frequency of clinical and dermoscopic features between BCC and TT in the studied group, differential diagnosis based on these variables is not reliable. Histopathological examination remains a diagnostic gold standard in differentiation of BCC and TT.
Collapse
Affiliation(s)
- Martyna Sławińska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Correspondence:
| | - Anna Płaszczyńska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Joanna Lakomy
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Krzysztof Pastuszak
- Department of Algorithms and System Modeling, Faculty of Electronics, Telecommunication and Informatics, Gdansk University of Technology, 80-233 Gdańsk, Poland
- Laboratory of Translational Oncology, Intercollegiate Faculty of Biotechnology, Medical University of Gdańsk, 80-210 Gdańsk, Poland
- Centre of Biostatistics and Bioinformatics Analysis, Medical University of Gdansk, 80-210 Gdańsk, Poland
| | - Wojciech Biernat
- Department of Pathomorphology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Monika Sikorska
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Roman J. Nowicki
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| | - Michał Sobjanek
- Department of Dermatology, Venereology and Allergology, Faculty of Medicine, Medical University of Gdańsk, 80-210 Gdańsk, Poland
| |
Collapse
|