Difference between revisions of "Template:Squamous-cell like skin proliferations - differential diagnosis"

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| [[Actinic keratosis]] || Atypical keratinocytes that do not span the full thickness of the epidermis (or, in Bowenoid variant, are less disordered with less nuclear atypia and crowding). || [[File:Micrograph of actinic keratosis - low magnification.jpg|190px]]
 
| [[Actinic keratosis]] || Atypical keratinocytes that do not span the full thickness of the epidermis (or, in Bowenoid variant, are less disordered with less nuclear atypia and crowding). || [[File:Micrograph of actinic keratosis - low magnification.jpg|190px]]
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| [[Basal-cell carcinoma]] with squamous cell metaplasia
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| Generally distinguishable by for example relatively less cytoplasm, palisading, cleft formations and absence of horn cyst formation. Yet, a high prevalence means a relatively high incidence of borderline cases, such as those with squamous cell metaplasia (pictured). BerEP4 staining helps in such cases, staining only basal-cell carcinoma cells (pictured).
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| [[File:BCC with squamous cell metaplasia with HE and BerEP4 staining, vertical layout.jpg|thumb|180px|Basal-cell carcinoma with squamous cell metaplasia, with HE and BerEP4 staining]]
 
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| Keratoacanthoma || Symmetrical and circumscribed proliferation of keratinocytes, with central horn plug, with epidermis that extends over the tumor. Highly differentiated SCC. || [[File:Keratoacanthoma (2197016163).jpg|190px]]
 
| Keratoacanthoma || Symmetrical and circumscribed proliferation of keratinocytes, with central horn plug, with epidermis that extends over the tumor. Highly differentiated SCC. || [[File:Keratoacanthoma (2197016163).jpg|190px]]

Revision as of 04:17, 5 March 2020

Author: Mikael Häggström [note 1]

Squamous cell-like skin proliferations: Differential diagnosis

Condition[1] Characteristics[1] Image
Invasive squamous-cell carcinoma of the skin Atypical and pleomorphic keratinocytes, involving the dermis and the sub-cutis with a potential metastatic spread. Micrograph of invasive squamous cell carcinoma - 150x.jpg
Squamous-cell carcinoma in situ (Bowen’s disease) Atypical keratinocytes at every layer of epidermis. Micrograph of squamous cell carcinoma in situ - 100x.jpg
Actinic keratosis Atypical keratinocytes that do not span the full thickness of the epidermis (or, in Bowenoid variant, are less disordered with less nuclear atypia and crowding). Micrograph of actinic keratosis - low magnification.jpg
Basal-cell carcinoma with squamous cell metaplasia Generally distinguishable by for example relatively less cytoplasm, palisading, cleft formations and absence of horn cyst formation. Yet, a high prevalence means a relatively high incidence of borderline cases, such as those with squamous cell metaplasia (pictured). BerEP4 staining helps in such cases, staining only basal-cell carcinoma cells (pictured).
Basal-cell carcinoma with squamous cell metaplasia, with HE and BerEP4 staining
Keratoacanthoma Symmetrical and circumscribed proliferation of keratinocytes, with central horn plug, with epidermis that extends over the tumor. Highly differentiated SCC. Keratoacanthoma (2197016163).jpg
Crush artifacts Needles used to orient the skin sample may create crush artifacts (black arrow) mimicking cellular atypia. Image also shows folding artifacts (white arrows). Skin with folds and crush artifact by needle.jpg
Adnexal carcinomas Squamous differentiation, but does not show connection with the epidermis and highlights adnexal features. Micrograph of microcystic adnexal carcinoma - superficial follicular keratin-filled cysts.jpg
Adenosquamous carcinoma Mixed glandular and squamous differentiation. Micrograph of cutaneous adenosquamous carcinoma - 40x.jpg
Verrucous squamous cell carcinoma[notes 1] Exophytic squamous proliferation with marked papillomatosis and low atypia and the presence of koilocyte-like changes. Found in head and neck locations, as well as in the genitalia and sole of the foot. Micrograph of penile verrucous carcinoma - 20x.jpg Micrograph of penile verrucous carcinoma - 200x.jpg
Inverted follicular keratosis[notes 2] Sharply circumscribed endophytic verrucous proliferation with prominent squamous features. Inverted follicular keratosis 1 (3059309003).jpg Inverted follicular keratosis 3 (3060145758).jpg
Seborrheic keratosis Acanthosis, absence of atypia, pseudo-horn cysts, in inflamed lesions, mitoses may be present. Histopathology of seborrheic keratosis.jpg
Bowenoid papulosis Atypical keratinocytes and mitoses. Histology similar to Bowen’s disease. Low-magnification micrograph of oral bowenoid papulosis.jpg High-magnification micrograph of oral bowenoid papulosis.jpg
Metastasis Personal medical history of the patient, nodular proliferation without connection to epidermis, immunohistochemical evaluation.
Squamous-cell carcinoma metastasis from lungs to the skin

Notes

    • Buschke–Löwenstein tumor is an alternative name for verrucous squamous cell carcinoma in the ano-genital region.
    • Carcinoma cuniculatum is a characteristic form of verrucous squamous cell carcinoma on the sole.
  1. Inverted follicular keratosis is generally thought to be a rare variant of seborrheic keratosis, but this position is not universally accepted.
    - Karadag, AyseSerap; Ozlu, Emin; Uzuncakmak, TugbaKevser; Akdeniz, Necmettin; Cobanoglu, Bengu; Oman, Berkant (2016). "Inverted follicular keratosis successfully treated with imiquimod ". Indian Dermatology Online Journal 7 (3): 177. doi:10.4103/2229-5178.182354. ISSN 2229-5178. 
  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 Initially copied from: Paolino, Giovanni; Donati, Michele; Didona, Dario; Mercuri, Santo; Cantisani, Carmen (2017). "Histology of Non-Melanoma Skin Cancers: An Update ". Biomedicines 5 (4): 71. doi:10.3390/biomedicines5040071. ISSN 2227-9059.  - "This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/)."

Image sources