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KNOW YOUR FIELD |
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Year : 2012 | Volume
: 16
| Issue : 1 | Page : 153-155 |
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Basaloid squamous cell carcinoma
V Poornima, Sangeeta R Patankar, S Gokul, Komal Khot
Department of Oral Pathology and Microbiology, Dr. G D Pol Foundation YMT Dental College and Hospital, Navi Mumbai, India
Date of Web Publication | 17-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
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/0973-029X.92997
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 |
Clinical Features | |  |
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 | |  |
- 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 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 | |  |
- 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 | |  |
Basaloid squamous cell carcinoma
[Figure 1], [Figure 2], [Figure 3], [Figure 4], [Figure 5], [Figure 6]
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