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An Official Publication of the Indian Association of Oral and Maxillofacial Pathologists


 
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Year : 2012  |  Volume : 16  |  Issue : 1  |  Page : 153-155
 

Basaloid squamous cell carcinoma


Department of Oral Pathology and Microbiology, Dr. G D Pol Foundation YMT Dental College and Hospital, Navi Mumbai, India

Date of Web Publication17-Feb-2012

Correspondence Address:
V Poornima
Department of Oral Pathology and Microbiology, Dr. G D Pol Foundation YMT Dental College and Hospital, Navi Mumbai
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-029X.92997

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How to cite this article:
Poornima V, Patankar SR, Gokul S, Khot K. Basaloid squamous cell carcinoma. J Oral Maxillofac Pathol 2012;16:153-5

How to cite this URL:
Poornima V, Patankar SR, Gokul S, Khot K. Basaloid squamous cell carcinoma. J Oral Maxillofac Pathol [serial online] 2012 [cited 2019 Sep 18];16:153-5. Available from: http://www.jomfp.in/text.asp?2012/16/1/153/92997



   Clinical Features Top


A 56-year-old male patient reported with the chief complaint of ill-fitting lower dentures. The patient was habituated to tobacco and pan chewing for the past 30 years. On clinical examination, a proliferative verrucous growth was noticed in the lower anterior region, extending from 33 to 43 and crossing the midline. The lesion was firm in consistency and nontender.


   Histopathology Top


  • Superficial parakeratinized stratified squamous surface epithelium is seen invading the underlying connective tissue [Figure 1].
  • Figure 1: Surface epithelium showing invasion into the connective tissue (H and E, ×4)

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  • The connective tissue stroma shows strands and islands of neoplastic epithelial cells. These islands show peripheral palisading basaloid-appearing cells with hyperchromatic nuclei, scanty cytoplasm, and central comedo-like necrosis [Figure 2],[Figure 3],[Figure 4] and [Figure 5].
  • Figure 2: Infiltrating strands of tumor epithelial cells showing keratin pearl formation and mitotic figures (H and E, ×10)

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    Figure 3: Islands showing peripheral palisading of basaloid cells (H and E, ×10)

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    Figure 4: Tumor islands showing comedo-like necrosis (H and E, ×10)

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    Figure 5: Tumor islands showing palisaded arrangement of peripheral basaloid cells (H and E, ×40)

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  • Keratin pearl formation and mitotic figures are evident in the infiltrating strands [Figure 6].
  • Figure 6: Photomicrograph showing mitotic figures and nuclear and cellular atypia (H and E, ×40)

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  • There is a squamous cell component interspersed among the basaloid islands.
  • The stroma shows chronic inflammatory cell infiltration.



   Differential Diagnosis Top


  • Basal cell carcinoma
  • Adenoid cystic carcinoma (solid variant)
  • Adenosquamous carcinoma
  • Basal cell adenocarcinoma
  • Salivary duct carcinoma
  • Neuroendocrine carcinoma


Adenoid cystic carcinoma (solid type)

  • Neoplastic myoepithelial and ductal cells are present.
  • Groups of cuboidal cells are seen, with dark nuclei and little tendency towards duct or cyst formation.
  • Squamous cell component and keratin pearl formation is absent.
  • Tumor cells show a swirling arrangement around the nerve bundles, indicating perineural invasion.


Adenosquamous carcinoma

  • Surface squamous cell component and deeper glandular component are more distinct.
  • Glandular structures are lined by basaloid, columnar, or mucin-secreting cells.
  • Intracytoplasmic mucin demonstrated by mucicarmine staining helps to differentiate this from the variants of squamous cell carcinoma that show a pseudoglandular pattern of differentiation.


Basal cell carcinoma

  • Nests of uniform-appearing tumor cells with scanty cytoplasm and large hyperchromatic oval nuclei, which shows peripheral palisading.
  • Increased mucin is present in the surrounding stroma, with cleft artifact occuring between tumor nests and surrounding stroma because of shrinkage of mucin during fixation and staining.
  • Pseudoglandular change and pigmented variants are noted occasionally.


Basal cell adenocarcinoma

  • Two forms of epithelial cells are seen, usually intermingled with each other-small round cells with scanty cytoplasm and dark basophilic nuclei and large polygonal cell with pale basophilic cytoplasm.
  • For the diagnosis of carcinoma there should be more than 4-5 mitotic figures per 10 high-powerfields.


Basal cell ameloblastoma

  • Islands of odontogenic epithelium lined peripherally by basaloid cells that tend to be cuboidal rather than columnar, surrounding central nests of uniform basaloid-appearing cells.
  • Absence of central comedo necrosis and any squamous component.


Salivary duct carcinoma

  • Tumor islands with large central cystic spaces with comedo type of necrosis and a several-cell-layers-thick peripheral rim of tumor cells that are cuboidal/polygonal and have a moderate amount of eosinophilic cytoplasm.
  • Perineural and perivascular invasion is common.



   Final Diagnosis Top


Basaloid squamous cell carcinoma


    Figures

  [Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]



 

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