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

表淺型基底細胞癌的多樣面貌-三不同病灶之臨床病理及免疫組織化學研究-

王國憲(Kuo-Hsien Wang) ； 方嘉郎(Chia-Lang Fang) ； 賴建仲(Chien-Chung Lai) ； 李婉若(Woan-Ruoh Lee)

《中華皮膚科醫學雜誌》 20卷4期 (2002/12) Pp. 335-343

摘要

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。

並列摘要

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.

並列關鍵字

Superficial basal cell carcinoma ； Histopathology ； Ki-67 ； bc1-2