Basal cell carcinoma with prominent central palisading of epithelial cells mimicking schwannoma

Abstract

Basal cell carcinoma (BCC), the most common malignant neoplasm of skin, may show a wide spectrum of histologic appearances. The presence of peripheral palisades is a very characteristic feature of BCC but, to our knowledge, central nuclear palisading has never been described. We report two cases of BCC exhibiting striking central nuclear palisading with Verocaylike bodies, in a pattern reminiscent of schwannoma. Peripheral palisades and clefts were also present in most tumor nodules and lobules, giving the neoplasms the overall configuration of otherwise typical solid BCC. In addition, foci of conventional BCC could be found adjacent, and in transition, to schwannoid areas. The immunohistochemical study showed strong reactivity for keratins (AE1 and AE3) in tumor cells, whereas no immunostaining for S-100 or muscle-specific actin was found. This previously undescribed histological feature of BCC should lead us to include BCC in the list of tumors to be considered in the differential diagnosis of a cutaneous neoplasm with schwannoid features.

Rippled-Pattern Sebaceoma: A Report of a Lesion on the Back With a Review of the Literature

“…16 Verocay bodies are an arrangement of nuclei of Schwann cells in 2 parallel rows enclosing a space of nearly homogeneous anuclear material. 17 Although Verocay bodies are often observed in schwannomas and neurofibromas, 17 similar findings have been reported in various other tumors, such as basal cell carcinoma, 18,19 pleomorphic adenoma, 20 dermatofibrosarcoma protuberans, 21 myofibroblastoma, 22,23 leiomyoblastoma, 23 trichoblastoma, and sebaceoma. These findings were described as central nuclear palisading, Verocay-like body, Verocay body-prominent, intranodal palisaded, intranodal palisading, or rippled-pattern.…”

Palisaded angioleiomyoma

“…Additional entities reported to have nuclear palisades include congenital neural hamartoma, 9 leiomyosarcoma, 10 malignant melanoma simulating schwann cell differentiation, 11 arteriovenous hemangioma, 12 and basal cell carcinoma. 13 Lespi and Smit recently reported a cutaneous leiomyoma in the lip of a 30-year-old female with prominent Verocay-like body formation. 14 The tumor reported here has features typical of angioleiomyoma, i.e., a well-circumscribed tumor consisting of fascicles of spindled cells associated with small blood vessels.…”

Hypopigmented Papules in Infancy: A Diagnostic Challenge: Answer

“…17 Basal cell carcinomas (BCC) may show similar palisading on histology, but will show other features of artefactual clefting and mucin deposition. 18 Mitoses are also more commonly seen in BCCs. It also typically affects patients older than 40 years.…”