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The Many Faces of Superficial Basal Cell Carcinoma -Clinicopathological and Immunohistochemical Studies of Three Different Lesions-


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表淺型基底細胞癌在組織學上皮腫瘤生物學上具有其獨特性,有別於其他型式基底細胞癌。由於它生長緩慢,臨床表現又與一般基底細胞癌迥異,診斷常易忽略。 本篇報告討論三例臨床表現各不相同的表淺型基底細胞癌,分別發生於兩位男性病人身上。三者病灶的組織學變化在腫瘤細胞島及其週邊組織成份上各自有別,反映出本型基底細胞癌複雜的影響因子以及其臨床上的差異。此外我們選擇Ki-67及bc1-2兩種免疫組織化學染色,比較本文三例表淺型基底細胞癌與另兩例毛囊上皮瘤,發現Ki-67於前者散在性表現而後著幾乎不表現。在bc1-2方面,前者均勻表現而後者僅在邊緣部位表現。兩者在Ki-67與bc1-2的表現差異反映其不同腫瘤生物行為,在診斷較具爭議之懷淺型基底細胞癌與毛囊上皮瘤時,K-67及bc1-2或可提供鑑別診斷之價值。


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Parallel abstracts

Superficial basal cell carcinoma is a distinct variant of basal cell carcinoma not only histological- ly but also biologically. Its indolent growth and occasionally misleading clinical presentation can sometimes pose a diagnostic challenge to clinicians. In this report, we describe three lesions of super-ficial basal cell carcinoma in two Taiwanese patients.Their clinical appearances were drastically dif-ferent from each other. The histopathology of the three lesions varied in the aspects of the tumor islands and the components of peritumoral stroma. The diverse clinicopathological pictures of superfi-cial BCC demonstrate the complex and conditioned pathogenesis of the tumor. In addition, immuno-histochemical studies with Ki-67 and bc1-2were performed on our cases and two cases of trichoep-ithelioma as well. Ki-67 is epressed in a random fashion within the tumor nests of superficial BCC, while trichoepithelioma is barely positive with Ki-67. Diffuse staining of bc1-2 is seen on the tumor nests of superficial BCC. In contrast, only the periphery of the tumor nests is bc1-2 positive in tri-choepithelioma. The differential immunostaining profile of the two lesions reflects their respective biological behaviors and may be of value in separating the two conditions in certain problematic cases.