Basal cell carcinoma classification: Difference between revisions
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__NOTOC__ | __NOTOC__ | ||
{{Basal cell carcinoma}} | {{Basal cell carcinoma}} | ||
{{CMG}} {{AE}} Saarah T. Alkhairy, M.D. | {{CMG}} {{AE}} Saarah T. Alkhairy, M.D.,{{M.N}} | ||
==Overview== | ==Overview== | ||
There is no well established [[classification]] for basal cell carcinoma, however there are few [[clinical]] variants which are [[nodular]], [[cystic]], sclerodermiform, infiltrated, micronodular, [[superficial]], and pigment basal cell carcinoma and fibroepithelioma of Pinkus. | |||
==Basal Cell Carcinoma Classification== | ==Basal Cell Carcinoma Classification== | ||
*There is no well established [[classification]] for the basal cell carcinoma of the [[skin]]<ref name="CameronLee2019">{{cite journal|last1=Cameron|first1=Michael C.|last2=Lee|first2=Erica|last3=Hibler|first3=Brian P.|last4=Barker|first4=Christopher A.|last5=Mori|first5=Shoko|last6=Cordova|first6=Miguel|last7=Nehal|first7=Kishwer S.|last8=Rossi|first8=Anthony M.|title=Basal cell carcinoma|journal=Journal of the American Academy of Dermatology|volume=80|issue=2|year=2019|pages=303–317|issn=01909622|doi=10.1016/j.jaad.2018.03.060}}</ref><ref name="DourmishevRusinova2013">{{cite journal|last1=Dourmishev|first1=LyubomirA|last2=Rusinova|first2=Darena|last3=Botev|first3=Ivan|title=Clinical variants, stages, and management of basal cell carcinoma|journal=Indian Dermatology Online Journal|volume=4|issue=1|year=2013|pages=12|issn=2229-5178|doi=10.4103/2229-5178.105456}}</ref> | |||
{| {{table}} | *However based on some [[evidence]] there are few [[clinical]] variants of basal cell carcinoma, the following table summarizes the [[classification]] of the [[clinical]] variants of basal cell carcinoma (BCC): | ||
{| {{table}} cellpadding="4" cellspacing="0" style="border:#c9c9c9 1px solid; margin: 1em 1em 1em 0; border-collapse: collapse;" | |||
| align="center" style="background:# | | align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Clinical Variants'''}} | ||
| align="center" style="background: #4479BA;" | {{fontcolor|#FFF|'''Description'''}} | |||
| align="center" style="background:# | |||
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| '''Nodular BCC'''||Comprises about 60-80% of cases; most commonly found on the skin of the head; '''clinically:''' elevated, exophytic pearl-shaped nodules with [[telangiectasias]] on the surface and periphery; '''histologically:''' nest-like infiltration from basaloid cells | | '''Nodular BCC'''||Comprises about 60-80% of cases; most commonly found on the [[skin]] of the [[head]]; '''[[Clinical|clinically]]:''' elevated, exophytic pearl-shaped [[nodules]] with [[telangiectasias]] on the [[Surface anatomy|surface]] and [[periphery]]; '''[[histologically]]:''' nest-like [[Infiltration (medical)|infiltration]] from basaloid [[Cells (biology)|cells]] | ||
|- | |- | ||
| '''Cystic BCC'''||≥ 1 cystic node with different sizes located peripherally to the | | '''Cystic BCC'''||≥ 1 [[cystic]] node with different sizes located peripherally to the [[central]]<nowiki/>ly placed [[tumor]] nests | ||
|- | |- | ||
| '''Sclerodermiform (morpheiform) BCC'''||The tumor cells are surrounded by fibrotic stroma; '''clinically:''' infiltrated plaque with a slightly shining surface and not well-defined borders; '''immunochemistry:''' expression of smooth muscle alpha-actin | | '''Sclerodermiform (morpheiform) BCC'''||The [[Tumor cell|tumor cells]] are surrounded by fibrotic [[stroma]]; [[Clinical|'''clinically''']]''':''' infiltrated [[plaque]] with a slightly shining surface and not well-defined borders; '''[[immunochemistry]]:''' expression of [[smooth muscle]] [[alpha-actin]] | ||
|- | |- | ||
| '''Infiltrated BCC'''||Most common found on the upper part of the trunk or face; '''clinically:''' whitish, compact, not well-defined plaque; '''histologically:''' thin, nest-like bundles of basaloid cells infiltrating in the dermal [[collagenous]] fibers | | '''Infiltrated BCC'''||Most common found on the upper part of the [[trunk]] or [[face]]; '''[[Clinical|clinically]]:''' whitish, [[Compact tissue|compact]], not well-defined [[plaque]]; '''[[histologically]]:''' thin, nest-like bundles of basaloid [[Cells (biology)|cells]] infiltrating in the [[dermal]] [[collagenous]] fibers | ||
|- | |- | ||
| '''Micronodular BCC'''||Most commonly found on the skin of the back; '''clinically:''' may be flat or elevated; yellow-whitish color when flat, clear outlines and thick at palpation; '''histologically:''' small rounded nodules of basaloid cells and minimal palisading | | '''Micronodular BCC'''||Most commonly found on the [[skin]] of the [[back]]; [[Clinical|'''clinically''']]''':''' may be flat or elevated; yellow-whitish color when flat, clear outlines and thick at [[palpation]]; '''[[histologically]]:''' small rounded [[nodules]] of basaloid [[Cells (biology)|cells]] and minimal palisading | ||
|- | |- | ||
| '''Superficial BCC'''||Comprises about 10-30% of cases; '''clinically:''' erythematous squamous plaque with clear borders, pearl-shape edge, superficial erosion, without tendencies for invasive growth; '''histologically:''' nests of basaloid cells located | | '''Superficial BCC'''||Comprises about 10-30% of cases; [[Clinical|'''clinically''']]''':''' [[erythematous]] [[squamous]] [[plaque]] with clear borders, pearl-shape edge, [[superficial]] erosion, without tendencies for [[invasive]] [[growth]]; '''[[histologically]]:''' nests of basaloid [[cells]] located sub[[Epidermal|epidermally]], connection with the basal layer of the [[epidermis]] and no [[Infiltration (medical)|infiltration]] of [[Tumor cell|tumor cells]] in the [[reticular dermis]] | ||
|- | |- | ||
| '''Pigment BCC'''||The color varies from dark brown to black; '''clinically:''' nodular, micronodular, multifocal, | | '''Pigment BCC'''||The [[color]] varies from dark [[brown]] to [[black]]; '''[[Clinical|clinically]]:''' [[nodular]], micronodular, multifocal, [[superficial]]; '''[[histologically]]:''' nests of basaloid [[cells]], [[melanocytes]] and melanophages, moderate [[inflammatory]] infiltrate | ||
|- | |- | ||
| '''Fibroepithelioma of Pinkus'''||Most commonly on the skin of the back; affects women especially; '''clinically:''' elevated pink or [[erythematous]] nodules; '''histologically:''' trabecular, elongated, and branched thin strands of basaloid cells | | '''Fibroepithelioma of Pinkus'''||Most commonly on the [[skin]] of the [[back]]; affects [[women]] especially; [[Clinical|'''clinically''']]''':''' elevated pink or [[erythematous]] [[nodules]]; '''[[histologically]]:''' [[Trabecular tissue|trabecular]], elongated, and branched thin strands of basaloid [[cells]] | ||
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==References== | ==References== | ||
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Latest revision as of 18:37, 4 April 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Saarah T. Alkhairy, M.D., Maneesha Nandimandalam, M.B.B.S.[2]
Overview
There is no well established classification for basal cell carcinoma, however there are few clinical variants which are nodular, cystic, sclerodermiform, infiltrated, micronodular, superficial, and pigment basal cell carcinoma and fibroepithelioma of Pinkus.
Basal Cell Carcinoma Classification
- There is no well established classification for the basal cell carcinoma of the skin[1][2]
- However based on some evidence there are few clinical variants of basal cell carcinoma, the following table summarizes the classification of the clinical variants of basal cell carcinoma (BCC):
| Clinical Variants | Description |
| Nodular BCC | Comprises about 60-80% of cases; most commonly found on the skin of the head; clinically: elevated, exophytic pearl-shaped nodules with telangiectasias on the surface and periphery; histologically: nest-like infiltration from basaloid cells |
| Cystic BCC | ≥ 1 cystic node with different sizes located peripherally to the centrally placed tumor nests |
| Sclerodermiform (morpheiform) BCC | The tumor cells are surrounded by fibrotic stroma; clinically: infiltrated plaque with a slightly shining surface and not well-defined borders; immunochemistry: expression of smooth muscle alpha-actin |
| Infiltrated BCC | Most common found on the upper part of the trunk or face; clinically: whitish, compact, not well-defined plaque; histologically: thin, nest-like bundles of basaloid cells infiltrating in the dermal collagenous fibers |
| Micronodular BCC | Most commonly found on the skin of the back; clinically: may be flat or elevated; yellow-whitish color when flat, clear outlines and thick at palpation; histologically: small rounded nodules of basaloid cells and minimal palisading |
| Superficial BCC | Comprises about 10-30% of cases; clinically: erythematous squamous plaque with clear borders, pearl-shape edge, superficial erosion, without tendencies for invasive growth; histologically: nests of basaloid cells located subepidermally, connection with the basal layer of the epidermis and no infiltration of tumor cells in the reticular dermis |
| Pigment BCC | The color varies from dark brown to black; clinically: nodular, micronodular, multifocal, superficial; histologically: nests of basaloid cells, melanocytes and melanophages, moderate inflammatory infiltrate |
| Fibroepithelioma of Pinkus | Most commonly on the skin of the back; affects women especially; clinically: elevated pink or erythematous nodules; histologically: trabecular, elongated, and branched thin strands of basaloid cells |
References
- ↑ Cameron, Michael C.; Lee, Erica; Hibler, Brian P.; Barker, Christopher A.; Mori, Shoko; Cordova, Miguel; Nehal, Kishwer S.; Rossi, Anthony M. (2019). "Basal cell carcinoma". Journal of the American Academy of Dermatology. 80 (2): 303–317. doi:10.1016/j.jaad.2018.03.060. ISSN 0190-9622.
- ↑ Dourmishev, LyubomirA; Rusinova, Darena; Botev, Ivan (2013). "Clinical variants, stages, and management of basal cell carcinoma". Indian Dermatology Online Journal. 4 (1): 12. doi:10.4103/2229-5178.105456. ISSN 2229-5178.