Basal cell carcinoma differential diagnosis: Difference between revisions
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==Overview== | ==Overview== | ||
There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, merkel cell carcinoma, and other squamous cell carcinoma. | There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, [[merkel cell carcinoma]], and other [[squamous cell carcinoma]]. | ||
==Basal Carcinoma Differential Diagnosis== | ==Basal Carcinoma Differential Diagnosis== | ||
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| '''Merkel cell carcinoma'''||This is a highly malignant neoplasm derived from cutaneous neuroendocrine cells<ref>{{cite journal| author=Massari LP, Kastelan M, Gruber F| title=Epidermal malignant tumors: pathogenesis, influence of UV light and apoptosis. | journal=Coll Antropol | year= 2007 | volume= 31 Suppl 1 | issue= | pages= 83-5 | pmid=17469758 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17469758}}</ref>||Histopathology: opaque nuclei, no nucleoli, and increased nuclear/cytoplasmic ratio, peripheral palisading might be present | | '''Merkel cell carcinoma'''||This is a highly malignant neoplasm derived from cutaneous [[neuroendocrine]] cells<ref>{{cite journal| author=Massari LP, Kastelan M, Gruber F| title=Epidermal malignant tumors: pathogenesis, influence of UV light and apoptosis. | journal=Coll Antropol | year= 2007 | volume= 31 Suppl 1 | issue= | pages= 83-5 | pmid=17469758 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17469758}}</ref>||Histopathology: opaque nuclei, no nucleoli, and increased nuclear/cytoplasmic ratio, peripheral palisading might be present | ||
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| '''Squamous cell carcinoma (SCC)'''||It may impossible to | | '''Squamous cell carcinoma (SCC)'''||It may impossible to distinguish between BCC and SCC<ref>{{cite journal| author=Raasch BA, Buettner PG, Garbe C| title=Basal cell carcinoma: histological classification and body-site distribution. | journal=Br J Dermatol | year= 2006 | volume= 155 | issue= 2 | pages= 401-7 | pmid=16882181 | doi=10.1111/j.1365-2133.2006.07234.x | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16882181}}</ref>||Histopathology: larger cells with prominent nucleoli, foci of keratinization and formation of squamous whorls where the neoplastic cells tightly wrap around each other | ||
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| '''Nodular BCC'''||Intradermal nevus | | '''Nodular BCC'''||Intradermal nevus | ||
Sebaceous hyperplasia | [[Sebaceous hyperplasia]] | ||
Fibrous papule | Fibrous papule | ||
Molluscum contagiosum | [[Molluscum contagiosum]] | ||
Keratoacanthoma | [[Keratoacanthoma]] | ||
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| '''Superficial BCC'''||Discoid eczema | | '''Superficial BCC'''||Discoid eczema | ||
Psoriasis | [[Psoriasis]] | ||
Actinic keratosis (solar keratosis) | [[Actinic keratosis]] (solar keratosis) | ||
Lichen simplex | Lichen simplex | ||
Bowen's disease | [[Bowen's disease]] | ||
Seborrhoeic keratosis | [[Seborrhoeic keratosis]] | ||
|- | |- | ||
| '''Pigment BCC'''||Melanoma | | '''Pigment BCC'''||[[Melanoma]] | ||
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| '''Sclerodermiform (morpheiform) BCC'''||Scar tissue | | '''Sclerodermiform (morpheiform) BCC'''||Scar tissue | ||
Localized scleroderma | Localized [[scleroderma]] | ||
|} | |} |
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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.
Overview
There are several differential diagnosis for basal cell carcinoma that may be differentiated clinically or histopathologically including microcystic adnexal carcinoma, trichoepithelioma/trichoblastoma, merkel cell carcinoma, and other squamous cell carcinoma.
Basal Carcinoma Differential Diagnosis
The following table summarizes common differential diagnosis for basal cell carcinoma[1]:
Disease or Condition | Differentiating Signs and Symptoms | Differentiating Tests |
Microcystic adnexal carcinoma | AKA sclerosing sweat duct carcinoma; simulate morpheaform variants of BCC; higher recurrence rate than BCC | Histopathology: there are more ductal structures lined by a cuticle of keratin, which are not prevalent in BCCs; it will occasionally be positive with cytokeratin 7 and CEA (usually negative in BCCs)[2] |
Trichoepithelioma/trichoblastoma | There is a formation of papillary-mesenchymal bodies (follicular units that simulate bulb of the hair follicle); a characteristic stroma-stroma split; a lower apoptotic and mitotic rate than seen in BCC[3] | Histopathology: the characteristic stroma-epithelium split and increase in apoptotic bodies and mitotic figures is not seen; Immunohistochemical: a characteristic perinuclear dot-like pattern and high molecular weight cytokeratin cocktail |
Merkel cell carcinoma | This is a highly malignant neoplasm derived from cutaneous neuroendocrine cells[4] | Histopathology: opaque nuclei, no nucleoli, and increased nuclear/cytoplasmic ratio, peripheral palisading might be present |
Squamous cell carcinoma (SCC) | It may impossible to distinguish between BCC and SCC[5] | Histopathology: larger cells with prominent nucleoli, foci of keratinization and formation of squamous whorls where the neoplastic cells tightly wrap around each other |
The following table summarizes other differential diagnosis for basal cell carcinoma:
Clinical Variant | Differential Diagnosis |
Nodular BCC | Intradermal nevus
Fibrous papule |
Superficial BCC | Discoid eczema
Actinic keratosis (solar keratosis) Lichen simplex |
Pigment BCC | Melanoma |
Sclerodermiform (morpheiform) BCC | Scar tissue
Localized scleroderma |
References
- ↑ https://online.epocrates.com/u/2935269/Basal+cell+carcinoma
- ↑ Smeets NW, Stavast-Kooy AJ, Krekels GA, Daemen MJ, Neumann HA (2003). "Adjuvant cytokeratin staining in Mohs micrographic surgery for basal cell carcinoma". Dermatol Surg. 29 (4): 375–7. PMID 12656816.
- ↑ Ackerman AB, Gottlieb GJ (2005). "Fibroepithelial tumor of pinkus is trichoblastic (Basal-cell) carcinoma". Am J Dermatopathol. 27 (2): 155–9. PMID 15798443.
- ↑ Massari LP, Kastelan M, Gruber F (2007). "Epidermal malignant tumors: pathogenesis, influence of UV light and apoptosis". Coll Antropol. 31 Suppl 1: 83–5. PMID 17469758.
- ↑ Raasch BA, Buettner PG, Garbe C (2006). "Basal cell carcinoma: histological classification and body-site distribution". Br J Dermatol. 155 (2): 401–7. doi:10.1111/j.1365-2133.2006.07234.x. PMID 16882181.