Differentiation between basal cell carcinoma and trichoepithelioma by immunohistochemical staining of the androgen receptor: an overview

Arits, A.H.M.M.; Marion, Ariënne M W van; Lohman, Bjorn G.P.M.; Thissen, M. R. T. M.; Steijlen, P.M.; Nelemans, Patty J.; Kelleners‐Smeets, Nicole W.J.

doi:10.1684/ejd.2011.1504

Cited by 25 publications

(26 citation statements)

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“…The 80 slides were reviewed based on the presence or absence of the following characteristics: tumour-stroma cleft formation, ulceration, epithelial primitive structures, small keratinous cysts, inflammatory response, mitosis, necrotic tumour cells, papillary mesenchymal bodies, stromal oedema and peritumoral mucin production. [5] Eventually, 35 TE were found to unambiguously fit the criteria for classic TE and these were used for the analysis, together with 45 BCC. All of the used samples and corresponding data were de-linked and anonymised.…”

Section: Methodsmentioning

confidence: 99%

“…[3] Later evidence shows that BCC can also arise from the hair follicle (HF) bulge. [4] Trichoepithelioma (TE) is a similar, though benign epithelial tumour which expresses markers that are also present in the outer root sheath of the HF [5], [6], which suggests that TE originate from the HF as well. Two distinct subtypes of TE are recognized: the classic and the desmoplastic type.…”

Section: Introductionmentioning

confidence: 99%

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Immunohistochemical Analysis of the Mechanistic Target of Rapamycin and Hypoxia Signalling Pathways in Basal Cell Carcinoma and Trichoepithelioma

et al. 2014

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BackgroundBasal cell carcinoma (BCC) is the most common cancer in Caucasians. Trichoepithelioma (TE) is a benign neoplasm that strongly resembles BCC. Both are hair follicle (HF) tumours. HFs are hypoxic microenvironments, therefore we hypothesized that hypoxia-induced signalling pathways could be involved in BCC and TE as they are in other human malignancies. Hypoxia-inducible factor 1 (HIF1) and mechanistic/mammalian target of rapamycin (mTOR) are key players in these pathways.ObjectivesTo determine whether HIF1/mTOR signalling is involved in BCC and TE.MethodsWe used immunohistochemical staining of formalin-fixed paraffin-embedded BCC (n = 45) and TE (n = 35) samples to assess activity of HIF1, mTORC1 and their most important target genes. The percentage positive tumour cells was assessed manually in a semi-quantitative manner and categorized (0%, <30%, 30–80% and >80%).ResultsAmong 45 BCC and 35 TE examined, expression levels were respectively 81% and 57% (BNIP3), 73% and 75% (CAIX), 79% and 86% (GLUT1), 50% and 19% (HIF1α), 89% and 88% (pAKT), 55% and 61% (pS6), 15% and 25% (pMTOR), 44% and 63% (PHD2) and 44% and 49% (VEGF-A). CAIX, Glut1 and PHD2 expression levels were significantly higher in TE when only samples with at least 80% expression were included.ConclusionsHIF and mTORC1 signalling seems active in both BCC and TE. There are no appreciable differences between the two with respect to pathway activity. At this moment immunohistochemical analyses of HIF, mTORC1 and their target genes does not provide a reliable diagnostic tool for the discrimination of BCC and TE.

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Section: Methodsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Analysis of the Mechanistic Target of Rapamycin and Hypoxia Signalling Pathways in Basal Cell Carcinoma and Trichoepithelioma

et al. 2014

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“…On the other hand, BCC is an epithelial tumor arising from progenitor cells of the interfollicular epidermis and upper infundibulum [1]. Clinical differentiation of TE from BCC can be difficult in some cases [2–7]. However, distinction between the two neoplasms is important because they have different biologic behavior and require different treatments.…”

Section: Discussionmentioning

confidence: 99%

“…It can sometimes be confused with basal cell carcinoma (BCC)—an epithelial tumor arising from progenitor cells of the interfollicular epidermis and upper infundibulum [1]—even with immunohistochemical examination including CD10, CD34, Bcl-2, cytokeratin 15 and 20, D2-40, and androgen receptor [2–7]. Differentiation of the two is important because their treatment is significantly different.…”

Section: Introductionmentioning

confidence: 99%

Trichoepithelioma Arising in an Ovarian Mature Cystic Teratoma

Suzuki

Nakayama

Muto

et al. 2016

Case Reports in Obstetrics and Gynecology

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Here, we report an extremely rare case of trichoepithelioma (TE)—a benign epithelial tumor originating from the outer root sheath of a hair follicle—arising in an ovarian mature cystic teratoma (MCT) with fluorodeoxyglucose-positron emission tomography (FDG-PET) findings. A 48-year-old Japanese woman presented to our hospital for her annual follow-up of adenomyosis. Ultrasonography and magnetic resonance imaging revealed a left ovarian tumor with irregular-shaped septum, which was suspicious of malignancy. However, tumor marker levels were within normal range. On FDG-PET, the maximum standardized uptake value (SUVmax) of the tumor was 2.9. Laparotomy with left salpingooophorectomy was performed. Pathologic examination revealed the probability of TE, rather than basal cell carcinoma (BCC), arising in an ovarian MCT. After five years of follow-up, the patient had no sign of recurrence. The FDG-PET SUVmax was low in TE, as with other benign tumor. However, future investigation is needed to evaluate the findings of FDG-PET imaging in TE cases.

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“…Some studies report that even focal expression of androgen receptor (AR) is characteristic of BCCs while absent staining is typical in benign trichoblastic tumours, such as TEs 24. However, other reports found AR expression in 5 of 8 cases of TEs, while 22 of 23 BCCs showed similar positive staining, questioning its utility 25. Another group used a panel consisting of p53, Bcl-2, proliferating cell nuclear antigen (PCNA) and Ki-67 and found that there was statistically significant increased staining of Ki-67 and PCNA in BCCs but diminished to absent staining in TEs.…”

Section: Cutaneous Adnexal Tumours With Follicular Lineagementioning

confidence: 99%

Challenges in the diagnosis of cutaneous adnexal tumours

et al. 2015

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The diagnosis of cutaneous adnexal neoplasms, a heterogeneous group of entities, is often perceived by practising pathologists as challenging. A systematic approach to diagnosis is necessary for classification of these lesions, which establishes the tumour differentiation (follicular, sebaceous, sweat gland or apocrine) and evaluates histological features differentiating between benign and malignant entities. Consideration of clinical history is a necessary adjunct in evaluation of the adnexal neoplasm, as characteristic anatomical sites are described for many adnexal lesions. In some instances, immunohistochemical studies may also be employed to aid the diagnosis. The differential diagnosis between primary cutaneous adnexal neoplasms and cutaneous metastases from visceral tumours may also be difficult. Clinical, radiological, histological and immunohistochemical characteristics will be further discussed, considering that the correct diagnosis has a significant impact on the patient's management and prognosis.

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Differentiation between basal cell carcinoma and trichoepithelioma by immunohistochemical staining of the androgen receptor: an overview

Cited by 25 publications

References 0 publications

Immunohistochemical Analysis of the Mechanistic Target of Rapamycin and Hypoxia Signalling Pathways in Basal Cell Carcinoma and Trichoepithelioma

Immunohistochemical Analysis of the Mechanistic Target of Rapamycin and Hypoxia Signalling Pathways in Basal Cell Carcinoma and Trichoepithelioma

Trichoepithelioma Arising in an Ovarian Mature Cystic Teratoma

Challenges in the diagnosis of cutaneous adnexal tumours

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