title: A Limited Immunohistochemical Panel to Distinguish Basal Cell Carcinoma of Cutaneous Origin From Basaloid Squamous Cell Carcinoma of the Head and Neck.
abstract: Head and neck carcinomas with basaloid features can be diagnostically challenging. A common diagnostic issue is the distinction between a basaloid squamous cell carcinoma (bSCC) and a basal cell carcinoma (BCC) of cutaneous origin. This is particularly true in small biopsy specimens where classic architectural and histologic features may be difficult to appreciate. A specific diagnosis is essential because of significant differences in clinical outcome and therapeutic management. Ten resection cases of bSCC and BCC of the head and neck were selected based on primary location and the classic morphologic features that characterize these 2 entities. The following immunohistochemical markers were evaluated: epithelial membrane antigen (EMA), Ber-EP4, CD44, Bcl2, androgen receptor, SOX2, and p16. The strongest statistically significant differences in staining patterns were for EMA, p16, and SOX2. EMA was positive in all bSCCs and negative in all BCCs. SOX2 was positive in all bSCCs and in only 3 out of 10 BCCs. Staining was weak and peripheral in the SOX2-positive BCCs. p16 was positive in 8 out of 10 bSCCs and negative in all BCCs. We conclude that bSCC and BCC of the head and neck can be readily distinguished by a limited panel consisting primarily of EMA, and supported by SOX2 and p16.
authors.affiliation: Department of Pathology and Laboratory Medicine, Jackson Memorial Hospital/University of Miami Miller School of Medicine, Miami, FL.
authors.forename: Gabriel
authors.initials: G
authors.lastname: Villada
authors.forename: Oleksandr N
authors.initials: ON
authors.lastname: Kryvenko
authors.forename: German
authors.initials: G
authors.lastname: Campuzano-Zuluaga
authors.forename: Christina
authors.initials: C
authors.lastname: Kovacs
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chapman
authors.forename: Carmen
authors.initials: C
authors.lastname: Gomez-Fernandez
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002280:Basal Cell Carcinoma / Q000175:diagnosis* / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000175:diagnosis* / Q000473:pathology; D019941:Cyclin-Dependent Kinase Inhibitor p16 / Q000378:metabolism*; D003937:Diagnosis, Differential; D005260:Female; D006258:Head and Neck Neoplasms / Q000175:diagnosis* / Q000473:pathology; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D018396:Mucin-1 / Q000378:metabolism*; D055748:SOXB1 Transcription Factors / Q000378:metabolism*; D012878:Skin Neoplasms / Q000175:diagnosis* / Q000473:pathology
chemical_list: C000614131:CDKN2A protein, human; D019941:Cyclin-Dependent Kinase Inhibitor p16; D018396:Mucin-1; C527782:SOX2 protein, human; D055748:SOXB1 Transcription Factors