Acantholytic Squamous Cell Carcinoma in Upper Aerodigestive Tract: Histopathology, Immunohistochemical Profile and Epithelial Mesenchymal Transition Phenotype Change

Abstract

Acantholytic squamous cell carcinoma is a rare variant of squamous cell carcinoma in the mucosa of upper aerodigestive tract. Histomorphologically, acantholytic squamous cell carcinoma may lose the typical features of conventional squamous cell carcinoma and mimic other epithelial or mesenchymal malignancies due to advanced acantholysis and dyskeratosis. Because of its rarity, information of prognosis, pathologic features and immunohistochemical profiles is limited. We have studied clinicopathologic features and immunohistochemical profiles of four acantholytic squamous cell carcinoma cases arising from upper aerodigestive tract. Clinical results indicate an aggressive biologic behavior. Morphologically, all tumors revealed significant acantholysis with separation of tumor cells and intratumoral spaces. The tumor cells were highly pleomorphic and growth patterns were variable. In immunohistochemical studies, all tumor cells revealed positive reactions for AE1/AE3 and p63 supporting a squamous epithelial origin. In contrast to conventional aerodigestive squamous cell carcinoma, acantholytic squamous cell carcinoma showed significant reductions of cytokeratin19, E-cadherin and concomitant up-regulation of vimentin expression. Both morphologic features and immunohistochemical profiles indicate that acantholytic squamous cell carcinoma has acquired an epithelial mesenchymal transition phenotype. However, in contrast to other solid malignant tumors, the epithelial mesenchymal transition phenotype change in acantholytic squamous cell carcinoma is not limited to the invasive front of the peripheral tumor but, rather, diffusely involves entire neoplastic lesion. In addition, because cytokeratin 19 staining is attenuated, this would be an insensitive marker for following up and/or in detecting disseminated tumor cells in cases of acantholytic squamous cell carcinoma in upper aerodigestive tract.

Metastatic submandibular acantholytic squamous cell carcinoma in a dog

“…Specifically, acantholytic squamous cell carcinoma (ASCC), also known as pseudoglandular carcinoma, is an uncommon histological variant of SCC (12,13) (7). In humans, this variant is rare, but it has been reported in the oral cavity (9,13), nasal cavity (1, 9), vulva (6), palate (9), maxilla (19), cecum (10) and breast (11). ASCC is also rare in animals, with only a few reports that have described ASCC in the mammary region (8) and oral cavity of dogs (4).…”

Adenoid dysplasia of the oral mucosa

“…carcinoma, basaloid squamous cell carcinoma, and ASCC, are well docu-mented and have prognostic significance. 5,6 This article documents the unique histomorphologic fea-tures in a case of oral epithelial dysplasia, which are reminiscent of those seen in ASCC. We have termed this unusual presentation adenoid dysplasia.…”

“…However, these features are evident throughout the tumor in cases of ASCC. 6,14,15 A recent study has found that increased vimentin expression within lesions of oral epithelial dysplasia closely correlates with histologic grade. This may represent a useful adjunct for the prediction of ma-lignant potential in high-risk lesions.…”

“…13,14 The combination of downregulation of E-cadherin, aberrant cytoplasmic expression of b-catenin, and coexpression of vimentin thus signifies EMT and is associated with greater risk for malignant transformation in dysplastic lesions and more aggressive behavior in invasive lesions. 6,13 The resultant loss of cell adhesion and the acquisition of cellular motility is an essential event in tumor cell invasion and distant spread. 9 The acantholytic dysplastic cells in AD presented here show a loss of E-cadherin expression and increased cytoplasmic expression of b-catenin.…”

Acantholytic squamous cell carcinoma of larynx as an uncommon variant of squamous cell carcinoma

“…[1][2][3][4] Hasta sayılarının azlığı nedeniyle prognoz hakkında net yorum yapılamamakla birlikte akantolitik SHK alt tipinin daha agresif seyrettiği bilinmektedir. [1][2][3][4] Baş-boyun kanserli hastalarda uzak metastaz riski %4 ile %25 arasında değişmektedir. [5] Metastazlar hematojen yolla en sık akciğer (%60) ve kemiğe (%20) olmaktadır.…”