Basaloid squamous cell carcinoma of the esophagus with or without adenoid cystic features.
BACKGROUND
Basaloid squamous cell carcinoma (BSCC) of the esophagus is a rare malignant tumor that morphologically could bear some resemblance to adenoid cystic carcinoma (ACC) originating from salivary glands.


OBJECTIVE
The purpose of this study is to describe the histologic, immunohistochemical, and ultrastructural findings of BSCCs of the esophagus, with an emphasis on comparing tumors with or without adenoid cystic features.


METHODS
We reviewed 239 cases of primary esophageal carcinoma and detected 12 cases (5%) of BSCC. The light and electron microscopic findings and immunocytochemical localization of various antigens, including cytokeratins (AE1, AE3), carcinoembryonic antigen, epithelial membrane antigen, S100, smooth muscle actin, and p53, were examined in these BSCC cases.


RESULTS
Histologically, all BSCCs were composed of solid lobules or nests of basaloid cells with well-demarcated outlines surrounded by a fibrous stroma. Seven of 12 tumors showed areas of ACC-like features, that is, cribriform-like pseudoglandular lumina formation and hyaline material surrounding the tumor nests, whereas the remaining 5 tumors were apparently pure basaloid carcinomas. These 2 groups of tumors were histologically and immunohistochemically identical in many aspects, namely, high-grade nuclei of the tumor cells with frequent mitoses, abundant comedo-type necrosis, focal areas of concomitant squamous differentiation, consistent immunoreactivity for cytokeratins, and poor or absent staining for S100 and smooth muscle actin. Ultrastructurally, the basaloid tumor cells exhibited relatively undifferentiated cellular characteristics and undeveloped cell organelles.


CONCLUSIONS
Basaloid squamous cell carcinomas of the esophagus frequently have an intimate association with ACC-like patterns, but their histologic, immunocytochemical, and ultrastructural features correspond more to poorly differentiated squamous cell carcinoma than to salivary gland ACC. This distinction is important because genuine ACC is much less aggressive than BSCC.
Li
Tie-Jun
TJ
Department of Oral Pathology, Peking University School of Stomatology, Beijing, People's Republic of China.
Zhang
Yong-Xin
YX
Wen
Julie
J
Cowan
Daniel F
DF
Hart
John
J
Xiao
Shu-Yuan
SY
D014408:Biomarkers, Tumor / Q000276:immunology; D003528:Carcinoma, Adenoid Cystic / Q000473:pathology* / Q000648:ultrastructure; D002280:Basal Cell Carcinoma / Q000473:pathology* / Q000648:ultrastructure; D002281:Carcinoma, Basosquamous / Q000473:pathology* / Q000648:ultrastructure; D002294:Carcinoma, Squamous Cell / Q000473:pathology* / Q000648:ultrastructure; D004938:Esophageal Neoplasms / Q000473:pathology* / Q000648:ultrastructure; D005260:Female; D006801:Humans; D007150:Immunohistochemistry / Q000379:methods; D008297:Male; D008854:Microscopy, Electron; D008875:Middle Aged; D016612:Paraffin Embedding / Q000379:methods; D012468:Salivary Gland Neoplasms / Q000473:pathology / Q000648:ultrastructure; D012469:Salivary Glands / Q000473:pathology / Q000648:ultrastructure
D014408:Biomarkers, Tumor