Download - Basal Cell Carcinoma Variations
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Basal cell carcinoma: Variations
Deba P Sarma, MDOmaha
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BCC: M 58, forehead
Basal cell carcinoma, nodular type
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A. Rounded or branched lobules of small
hyperchromatic cells in the dermis with connectionto the overlying epidermis by narrow cords or broadtrabeculae.
B. Peripheral nuclear palisading.
C. Stroma is fibromyxoid.
D. Stroma retracts from the tumor lobules due toformalin fixation.
Basal cell carcinoma, nodular type
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BCC: M 74, right arm
Basal cell carcinoma,cystic type
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Basal cell carcinoma, cystic type
A.Variation of nodular BCC showing mucinousdegeneration in the center of the nodules
giving rise to cysts.
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BCC: M 87, nose
Basal cell carcinoma, nodulocystic type
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Basal cell carcinoma, nodulocystic type
A.Combination of nodular and cystic pattern.
B. 70% of all BCCs are nodulocystic type.
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BCC: F 45, left thigh
Superficial basal cell carcinoma
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A. Buds of dark basaloid cells with prominentperipheral nuclear pallisading are attached tothe basal layer of the epidermis.
B. Basaloid buds are separated along the basallayer by normal epidermal basal cuboidalcells.
C. Superficial basal cell carcinoma constitutesabout 15% of BCC's, nodular type being themost common type (70%).
D. Superficial BCC occurs most commonly onthe trunk.
Superficial basal cell carcinoma
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BCC: M 67, left forehead
Basal cell carcinoma, pilar type ( Keratotic basal cell carcinoma)
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Basal cell carcinoma, pilar type ( Keratotic basalcell carcinoma)
A.Nodular BCC with rounded collection of redcompact keratin in the center of the nodules
(pilar differentiation).
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BCC: M 73, forehead
Sclerosing basal cell carcinoma ( Morpheaform basal cell carcinoma)
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Sclerosing basal cell carcinoma ( Morpheaform basal
cell carcinoma)
A. Narrow cords, small groups and linear single smalldark basaloid cells within dense, collagenized stroma in
the dermis.
B. Note the solid large island of typical BCC in thesuperficial part.
C. Stromal retraction around the tumor cell islands maybe absent.
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BCC, M 81, back.
Pigmented basal cell carcinoma
A. Nodular BCC.B. Melanin pigments in the tumocells and in the stroma.
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BCC: M 84, left arm
Basal cell carcinoma, trichoepithelioma type
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Basal cell carcinoma, trichoepithelioma type
In many cases in adults, basal cell carcinomamay resemble trichoepithelioma.
These cases should be treated like basal cell
carcinoma with complete removal. My preferred term for such tumor is
BCC, trichoepithelioma type.
Ref: AFIP Atlas of Tumor Pathology. 4thSeries,Fascicle 4, Nonmelanocytic tumors ofthe skin. 2006, page 80.
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BCC: F 79, nose
bcl-2 Ber-Ep4
Metatypical basal cell carcinoma
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A. Loosely circumscribed dermal proliferation of lobules ofepitheliod cells with eosinophilic cytoplasm.
B. Few giant cells.
C. Atrophic epidermis.
D. No direct connection between the epidermis and the
dermal neoplastic proliferation.
E. No clefting.F. The tumor cells are positive for pancytokertatin (AE1:3),
bcl-2, and BerEp4.
Metatypical basal cell carcinoma
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BCC: M 72, right scalp
Basal cell carcinoma, infiltrative type
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A. Infiltrative basal cell carcinoma is a hybrid between nodulocysticand morpheaform BCC.
B. Expansile nodules mixed with branched, angulated and linearbasaloid cells.
B. Epidermal ulceration and deep dermal invasion with perineuralinvasion is common.Stroma is cellular.
B. Retraction artefact around the branched and angulated basaloidinfiltrates are not present.
Basal cell carcinoma, infiltrative type
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BCC: M 82, buttock
Fibroepithelioma of PinkusBasal cell carcinoma, fibroepithelioma of Pinkus type
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A. Fibroepithelioma of Pinkus (FEP) was first described by HermanPinkus in 1953.
B. FEP is currently accepted as a variant of basal cell carcinoma (BCC).
C. Mostly male, 4060 years of age.
D. Single or multiple pedunculated or sessile nodules with broad base onthe trunk or extremities.
E. Tumor is composed of long, thin, and branching strands of basal cell
carcinoma anastomosing in fibrovascular stroma.
Basal cell carcinoma, fibroepithelioma of pinkus type
Fibroepithelioma of Pinkus
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