Nigel J Ball1, Grace Tanhuanco-Kho. 1. Departments of Pathology and Dermatology, The University of British Columbia and Vancouver General Hospital, 855 West 12th Avenue, Vancouver, British Columbia, Canada. nigel.ball@vch.ca
Abstract
BACKGROUND: Merkel cell carcinoma (MCC) is a basaloid cutaneous neoplasm that may be mistaken for basal cell carcinoma (BCC). METHODS: Thirty MCCs were examined for areas that histologically resembled BCC. RESULTS: One of the histologic features of BCC (either a mucinous stroma or stromal artifactual retraction) was identified in all MCCs. A mucinous stroma was found in 28 MCCs (93%), stromal artifactual retraction in 27 (90%), mucin-containing gland-like spaces within tumor nests in 8 (27%), focal peripheral palisading in 8 (27%), epidermal involvement in 3 (10%) and dystrophic calcification in 1 MCC (3%). The cytologic features and absence of widespread peripheral palisading were the most reliable discriminators between MCC and BCC on routine sections. Squamous cell carcinoma was identified in four cases (13%). Two cases (7%) contained pagetoid intraepidermal spread (IES) of MCC. In one case, there was IES over the entire epidermal surface associated with intranuclear clearing, resembling the intranuclear cytoplasmic inclusions (INI) common in melanocytic tumors. INI were identified in six MCCs (20%). CONCLUSIONS: MCCs frequently contain areas that histologically resemble BCC and other more common cutaneous malignancies. This can lead to diagnostic errors, particularly in small fragmented curettage specimens or frozen sections.
BACKGROUND:Merkel cell carcinoma (MCC) is a basaloid cutaneous neoplasm that may be mistaken for basal cell carcinoma (BCC). METHODS: Thirty MCCs were examined for areas that histologically resembled BCC. RESULTS: One of the histologic features of BCC (either a mucinous stroma or stromal artifactual retraction) was identified in all MCCs. A mucinous stroma was found in 28 MCCs (93%), stromal artifactual retraction in 27 (90%), mucin-containing gland-like spaces within tumor nests in 8 (27%), focal peripheral palisading in 8 (27%), epidermal involvement in 3 (10%) and dystrophic calcification in 1 MCC (3%). The cytologic features and absence of widespread peripheral palisading were the most reliable discriminators between MCC and BCC on routine sections. Squamous cell carcinoma was identified in four cases (13%). Two cases (7%) contained pagetoid intraepidermal spread (IES) of MCC. In one case, there was IES over the entire epidermal surface associated with intranuclear clearing, resembling the intranuclear cytoplasmic inclusions (INI) common in melanocytic tumors. INI were identified in six MCCs (20%). CONCLUSIONS: MCCs frequently contain areas that histologically resemble BCC and other more common cutaneous malignancies. This can lead to diagnostic errors, particularly in small fragmented curettage specimens or frozen sections.
Authors: Melissa P Pulitzer; A Rose Brannon; Michael F Berger; Peter Louis; Sasinya N Scott; Achim A Jungbluth; Daniel G Coit; Isaac Brownell; Klaus J Busam Journal: Mod Pathol Date: 2015-05-29 Impact factor: 7.842
Authors: Neil Renwick; Pavol Cekan; Paul A Masry; Sean E McGeary; Jason B Miller; Markus Hafner; Zhen Li; Aleksandra Mihailovic; Pavel Morozov; Miguel Brown; Tasos Gogakos; Mehrpouya B Mobin; Einar L Snorrason; Harriet E Feilotter; Xiao Zhang; Clifford S Perlis; Hong Wu; Mayte Suárez-Fariñas; Huichen Feng; Masahiro Shuda; Patrick S Moore; Victor A Tron; Yuan Chang; Thomas Tuschl Journal: J Clin Invest Date: 2013-06 Impact factor: 14.808
Authors: Christopher K Bichakjian; Thomas Olencki; Sumaira Z Aasi; Murad Alam; James S Andersen; Rachel Blitzblau; Glen M Bowen; Carlo M Contreras; Gregory A Daniels; Roy Decker; Jeffrey M Farma; Kris Fisher; Brian Gastman; Karthik Ghosh; Roy C Grekin; Kenneth Grossman; Alan L Ho; Karl D Lewis; Manisha Loss; Daniel D Lydiatt; Jane Messina; Kishwer S Nehal; Paul Nghiem; Igor Puzanov; Chrysalyne D Schmults; Ashok R Shaha; Valencia Thomas; Yaohui G Xu; John A Zic; Karin G Hoffmann; Anita M Engh Journal: J Natl Compr Canc Netw Date: 2018-06 Impact factor: 12.693
Authors: Karolina Stachyra; Monika Dudzisz-Śledź; Elżbieta Bylina; Anna Szumera-Ciećkiewicz; Mateusz J Spałek; Ewa Bartnik; Piotr Rutkowski; Anna M Czarnecka Journal: Int J Mol Sci Date: 2021-06-11 Impact factor: 5.923