Squamous-cell carcinoma

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Author: Mikael Häggström [note 1]
Squamous-cell carcinoma (SCC):

Locations

Use the location-specific article when applicable:

Microscopic evaluation

  • Main characteristics of squamous-cell carcinoma

  • Typical well-differentiated nests have cells with abundant eosinophilic cytoplasm. Keratinizing centers are seen as well.

To support the diagnosis of a suspected squamous-cell carcinoma, immunohistochemistry can be used, including p63 and p40.

Degree of differentiation

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  • Well-differentiated (and yet invasive) SCC, showing prominent keratinization and may form “pearllike” structures where dermal nests of keratinocytes attempt to mature in a layered fashion. Well-differentiated SCC has slightly enlarged, hyperchromatic nuclei with abundant amounts of cytoplasm. Intercellular bridges will frequently be visible.[1]

  • Moderately differentiated lesions of invasive SCC show much less organization and maturation with significantly less keratin formation.[1]

  • Poorly differentiated, where attempts at keratinization are often no longer evident. This is a clear-cell squamous cell carcinoma. The dysplastic cells here infiltrate in cords through the dermis. Poorly differentiated SCC has greatly enlarged, pleomorphic nuclei demonstrating a high degree of atypia and frequent mitoses.[1]

  • Poorly differentiated clear-cell squamous cell carcinoma. For this type of SCC, immunostains will likely be required to classify it unless other areas of the tumor show obvious squamous cell features such as seen here (keratinization in center).

Cytology

Cytopathology of squamous cell carcinoma, nonkeratinizing variant, with typical features.[2] Pap stain. For a case of a case of high-grade squamous intraepithelial lesion, necrotic debris (dirty background) is a feature that generally makes the case "suspicious for invasive squamous cell carcinoma".[3] In contrast to the more distinct keratinizing variant, these findings are overall less specific, and most can be seen in other cancers such as adenocarcinoma as well (which, however, tends to have fine chromatin)[4]

  • Cytopathology of squamous cell carcinoma, keratinizing variant, with typical features.[5] Pap stain.

Further workup

Immunohistochemistry for p16 highly correlates with HPV infection, and is indicated mainly in cervical dysplasia, but also in SCC of other sites where HPV infection is more or less frequently implicated, including vagina, vulva, penis, anus, tonsil and other oropharyngeal locations.[6]

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ 1.0 1.1 1.2 Yanofsky, Valerie R.; Mercer, Stephen E.; Phelps, Robert G. (2011). "Histopathological Variants of Cutaneous Squamous Cell Carcinoma: A Review ". Journal of Skin Cancer 2011: 1–13. doi:10.1155/2011/210813. ISSN 2090-2905. .
    -"This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited."
  2. ↑ - Image annotated by Mikael Häggström
    - Reference for entries: Gulisa Turashvili, M.D., Ph.D.. Cervix - Squamous cell carcinoma and variants. Pathology Outlines. Last author update: 24 September 2020. Last staff update: 4 April 2022.
    - Source image by Ravi Mehrotra, Anurag Gupta, Mamta Singh and Rahela Ibrahim (Creative Commons Attribution 2.0 Generic license.)
  3. ↑ Alrajjal A, Pansare V, Choudhury MSR, Khan MYA, Shidham VB (2021). "Squamous intraepithelial lesions (SIL: LSIL, HSIL, ASCUS, ASC-H, LSIL-H) of Uterine Cervix and Bethesda System. ". Cytojournal 18: 16. doi:10.25259/Cytojournal_24_2021. PMID 34345247. PMC: 8326095. Archived from the original. . 
  4. ↑ Authors: Caroline I.M. Underwood, M.D., Alexis Musick, B.S., Carolyn Glass, M.D., Ph.D.. Adenocarcinoma overview. Pathology Outlines. Last staff update: 19 July 2022
  5. ↑ - Image annotated by Mikael Häggström
    - Reference for entries: Gulisa Turashvili, M.D., Ph.D.. Cervix - Squamous cell carcinoma and variants. Pathology Outlines. Last author update: 24 September 2020. Last staff update: 4 April 2022.
    - Source image from National Cancer Institute (Public Domain)
  6. ↑ Erika M. Baardsen, D.O., Marilin Rosa, M.D.. Cervix - Premalignant / preinvasive lesions - H&E - HPV. Pathology Outlines. Last author update: 1 December 2017. Last staff update: 5 May 2021

Image sources


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