BACKGROUND: The morpheaform subtype of basal cell carcinoma (BCC) often presents a diagnostic histological challenge, and its true margin may be difficult to determine with accuracy. This tumor may also be difficult to distinguish from other adnexal neoplasms having a benign clinical course. Previous work has shown that cytokeratin 17 (CK17 or K17) expression is high in BCC. OBJECTIVE: To confirm the expression of K17 across the subtypes of superficial, nodular and morpheaform BCC variants and to compare K17 expression in each of these subtypes of BCC with that in two other adnexal neoplasms. METHODS: Tissue specimens from each tumor category were randomly collected, immunolabeled, and scored for K17 expression according to intensity and extent of immunostaining. RESULTS: Our results indicate that K17 is a useful marker in the identification and outlining of BCC. Moreover, in morpheaform BCC, K17 immunostaining clearly detected individual tumor cells well away from the dermal tumor strands that otherwise seemed nonmalignant according to hematoxylin and eosin staining alone. In addition, the expression of K17 in morpheaform BCC is capable (100% of specimens; p < .001) of distinguishing this tumor from desmoplastic trichoepithelioma. CONCLUSION: We propose that K17 immunostaining could improve the diagnostic and surgical management of these tumors.
BACKGROUND: The morpheaform subtype of basal cell carcinoma (BCC) often presents a diagnostic histological challenge, and its true margin may be difficult to determine with accuracy. This tumor may also be difficult to distinguish from other adnexal neoplasms having a benign clinical course. Previous work has shown that cytokeratin 17 (CK17 or K17) expression is high in BCC. OBJECTIVE: To confirm the expression of K17 across the subtypes of superficial, nodular and morpheaform BCC variants and to compare K17 expression in each of these subtypes of BCC with that in two other adnexal neoplasms. METHODS: Tissue specimens from each tumor category were randomly collected, immunolabeled, and scored for K17 expression according to intensity and extent of immunostaining. RESULTS: Our results indicate that K17 is a useful marker in the identification and outlining of BCC. Moreover, in morpheaform BCC, K17 immunostaining clearly detected individual tumor cells well away from the dermal tumor strands that otherwise seemed nonmalignant according to hematoxylin and eosin staining alone. In addition, the expression of K17 in morpheaform BCC is capable (100% of specimens; p < .001) of distinguishing this tumor from desmoplastic trichoepithelioma. CONCLUSION: We propose that K17 immunostaining could improve the diagnostic and surgical management of these tumors.
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