Nomenclature for very superficial squamous cell carcinoma of the skin and of the cervix: a critique in historical perspective.
Squamous-cell carcinoma is the most common of all cancers and it develops in diverse organs of the body, among those being the skin, lung, gastrointestinal tract, and genitourinary tract, the latter including the cervix. Unfortunately, no unanimity exists for naming very superficial squamous-cell carcinoma; it has not been designated in consistent fashion in a single organ, let alone in all of them, thereby resulting in confusion, not only in regard to terminology per se, but concerning matters conceptual, not the least of those being what appellation to apply to that condition when it is encountered histopathologically. This vexing situation is illustrated graphically in the skin by diagnoses for very superficial squamous-cell carcinoma as disparate as solar keratosis (actinic keratosis, senile keratosis), arsenical keratosis, radiation keratosis, Bowen disease, bowenoid papulosis, squamous-cell carcinoma in situ, as well as variations on the theme of "keratinocytic intraepidermal neoplasia" and "dysplasia," and in the cervix by squamous-cell carcinoma in situ, leukoplakia, cervical intraepithelial neoplasia I-III, as well as variations on the theme of "squamous dysplasia ()." What follows now is a recounting of the history of the subject under consideration here, a critique of dizzying, opaque terms and phrases given to that subject, and a proposal for rectifying what currently is a thoroughly untenable situation because the language, and the ideas expressed by it, are impenetrable to physicians and, thereby, are decidedly disadvantageous to patients. There is a need urgently for a single term for very superficial squamous-cell carcinoma in every organ of the body in which it develops, to wit, one that conveys diagnosis in such logical, lucid, comprehensible fashion that it is understandable, readily and immediately, to clinicians. In that way, physicians charged with management of patients can plan therapy rationally.
Kessler
Galen M
GM
Ackerman Academy of Dermatopathology, 145 E 32 St, Fl 10, New York, NY 10016, USA. abernard@ameripath.com
Ackerman
A Bernard
AB
D002294:Carcinoma, Squamous Cell / Q000145:classification* / Q000266:history / Q000473:pathology; D005260:Female; D049672:History, 19th Century; D049673:History, 20th Century; D006801:Humans; D012878:Skin Neoplasms / Q000145:classification* / Q000266:history / Q000473:pathology; D002583:Uterine Cervical Neoplasms / Q000145:classification* / Q000266:history / Q000473:pathology