Use of Cytology in the Diagnosis of Basal Cell Carcinoma Subtypes

Abstract

Background: Basal cell carcinoma (BCC) is the most common skin cancer in the white population. Nonsurgical treatments are first-line alternatives in superficial BCC (sBCC); therefore, differentiating between sBCC and non-sBCC is of major relevance for the clinician. Scraping cytology possesses several advantages, such as an earlier diagnosis and scarring absence, in comparison to a biopsy. Nevertheless, previous studies reported difficulties in differentiating the different BCC subtypes. The objective of this study was to determine the capability and accuracy of scraping cytology to differentiate between sBCC and non-sBCC. Methods: In this retrospective study, cytological samples of histologically confirmed BCC were examined. Select cytological features were correlated to BCC subtypes (sBCC or non-sBCC). Results: A total of 84 BCC samples were included (29 sBCC; 55 non-sBCC). An inverse correlation between the diagnosis of sBCC and the presence of mucin, dehiscence, and grade of atypia in the basal cells was observed. The presence of medium and large basal cell clusters correlated directly to a sBCC diagnosis. The presence of clear cells is strongly associated with sBCC. Therefore, Conclusion: Scraping cytology is reliable in differentiating sBCC from other BCC subtypes.

"Diagnostic Significance of Fine Needle Biopsy and Cell Block in Skin and Subcutaneous Nodules"

“…In cases of dermoid cysts or implantation cysts, the smear showed a mixture degenerated epithelial cells and keratinous material, a picture found also by [16], but the cell block also usually failed due to the keratinous material.In cases of atypical lipomas, FNAC smear showed a very useful picture; pleomorphic, hyperchromatic lipoblasts, mucoid background; the cell block did not add a more information. In cases of basal cell carcinoma; FNAC smear showed malignant cells with basophilic cytoplasm; the same results were found by [17], but the orientation of cells appeared in the cell block with peripheral palisading. In cases of squamous cell carcinoma, the malignant epithelial cells and the individual cell keratinization appeared in the smear.…”

High‐Frequency Ultrasound and Shear Wave Elastography in Quantitative Differential Diagnosis of High‐Risk and Low‐Risk Basal Cell Carcinomas

“…Predicting the recurrence risk of BCCs before treatment had always been a research hotspot. Pasquali et al 4 use cytology to diagnosis superficial BCC, which is susceptible of nonsurgical treatment, and found an inverse correlation between the diagnosis of superficial BCC and the presence of mucus, dehiscence, and atypical grade in the basal cells. Wortsman et al 14 reported that a higher hyperechoic spots count was found in high‐risk BCCs, with sensitivity of 79% and specificity of 53% for predicting high‐risk BCCs using cut‐off point ≥7 hyperechoic spots.…”

“…3 Preoperative biopsy is mainly used to identify highrisk from low-risk BCC in clinical practice, but biopsy requires manipulation of the sample and often leave scarring, which is best avoided if BCC is susceptible to nonsurgical treatment, especially on the face. 4 Furthermore, preoperative biopsy represents only one sample of the tumor and may not include all the histological characteristics of the entire lesion. 5 A new noninvasive technique to determine the risk of BCC recurrence prior to treatment will undoubtedly be of great help in the development of clinical treatment plans.…”

Basal cell carcinoma cytology revisited – a modern perspective on an old technique

“…To our knowledge, the most commonly described sample collection technique is scrape cytology. With this technique, the tissue is obtained by scraping the tumor or scratching a part of the lesion off, both performed with a scalpel blade (5,6). Imprint smear cytology is a useful alternative for easily exfoliating ulcerated lesions.…”