DermatopathologyBasal cell (trichoblastic) carcinoma: Common expression pattern for epithelial cell adhesion molecule links basal cell carcinoma to early follicular embryogenesis, secondary hair germ, and outer root sheath of the vellus hair follicle: A clue to the adnexal nature of basal cell carcinoma?
Section snippets
Specimens
Skin samples from 30 human embryos and fetuses between the ages of 9 and 25 weeks of gestation were obtained from elective abortions performed in 1989 in Germany and in the Netherlands. The specimens were collected in conjunction with the guidelines enacted in both countries. The ages of the embryos and fetuses were determined by measuring the foot length.12, 13 and are reported in weeks after conception. Twenty scalp specimens from 22 of the total of 30 embryos and 29 feet samples from 24 of
Results
Ep-CAM is expressed early at the pregerm stage (Fig 1, A) of follicular embryogenesis, and can be found at low levels in the epithelial component (Fig 1, B). The immunopositivity increases dramatically in the subsequent germ stage (Fig 1, C) where strong expression for the Ber-Ep4 antigen becomes apparent in the entire epithelial component but not in the surrounding condensed mesenchymal cells (Fig 1, D). The pattern of expression for Ep-CAM changes again in the hair peg stage (Fig 1, E),
Discussion
In contrast to tumors with unequivocal signs of follicular differentiation (eg, the papillary mesenchymal bodies in trichoepithelioma or the shadow cells imitating the hair matrix in pilomatricoma), BCC has a less obvious follicular nature when observed in hematoxylin-eosin–stained sections. The lack of morphologic clues of follicular differentiation in most BCCs relates to the primitive features of the tumor. The morphologic resemblance of BCC, especially of the superficial type, to the hair
References (35)
- et al.
Essential role for sonic hedgehog during hair follicle morphogenesis
Dev Biol
(1999) - et al.
Fetal foot length as a predictor of gestational age
Am J Obstet Gynecol
(1987) - et al.
Carcinoma-associated 38-kD membrane glycoprotein MH 99/KS 1/4 is related to proliferation and age of transformed epithelial cell lines
J Invest Dermatol
(1994) - et al.
Expression of 38-kD cell-surface glycoprotein in transformed human keratinocyte cell lines, basal cell carcinomas, and epithelial germs
J Invest Dermatol
(1990) - et al.
Basaloid/follicular hyperplasia overlying connective tissue/mesenchymal hamartomas simulating basal cell carcinomas
J Am Acad Dermatol
(2001) - et al.
Hairy math: insights into hair-follicle spacing and orientation
Cell
(2007) - et al.
Electron microscopic studies of palmar and plantar pits of nevoid basal cell epithelioma
J Invest Dermatol
(1972) - et al.
A role for p75 neurotrophin receptor in the control of hair follicle morphogenesis
Dev Biol
(1999) - et al.
Loss of membranous Ep-CAM in budding colorectal carcinoma cells
Mod Pathol
(2007) - et al.
Basal cell carcinoma of the nail unit
J Am Acad Dermatol
(2007)
Tumors and cysts of the epidermis
Skin pathology
Tumors of the surface epithelium
Solid basal cell epithelioma (BCE) possibly originates from the outer root sheath of the hair follicle
Acta Derm Venereol
Basal cell carcinoma possibly originates from the outer root sheath and/or the bulge region of the vellus hair follicle
Arch Dermatol Res
Induction of the hair growth phase in postnatal mice by localized transient expression of sonic hedgehog
J Clin Invest
Cited by (37)
Basal cell carcinoma
2023, Ophthalmic Pathology: The Evolution of Modern ConceptsImpact of expert pathology review in skin adnexal carcinoma diagnosis: Analysis of 2573 patients from the French CARADERM network
2022, European Journal of CancerCitation Excerpt :Because PTT and trichoblastic carcinoma/carcinosarcoma are recently proposed WHO entities, further studies will be needed to confirm their frequency. The distinction between trichoblastic carcinoma/carcinosarcoma and BCC is also challenging and may need further refinement of their pathological and molecular diagnostic criteria in the future [12–16]. Among sweat gland carcinomas, the most frequent subtype in our study was porocarcinoma (28%; representing 11.8% of all adnexal carcinomas).
Spatiotemporal expression pattern of neuroepithelial stem cell marker nestin suggests a role in dermal homeostasis, neovasculogenesis, and tumor stroma development: A study on embryonic and adult human skin
2010, Journal of the American Academy of DermatologyCitation Excerpt :Nestin is also expressed in the peritumoral stroma of basal cell carcinoma and moreover spatially restricted to a one- to two-layered thin sheath of fibroblasts in the immediate vicinity of the epithelial component of basal cell carcinoma, whereas the peritumoral mesenchymal cells further away from the tumor were nestin-negative. This peritumoral expression pattern imitates that of nestin in the papilla of the early anagen terminal hair follicle; the pregerm, germ, and hair peg stage of the embryonic human hair follicle; and the lower CTS of the postnatal terminal hair follicle, confirming an increasing conceptual understanding of basal cell carcinomas as follicular neoplasms.18,19 Although we have chosen the superficial variant of basal cell carcinoma because of its already close resemblance on hematoxylin-eosin–stained sections to the embryonic hair germ, the same expression pattern is found in other variants of basal cell carcinoma such as the nodular and morpheaform subtypes (Krahl and Sellheyer, 2009, in preparation).
Basal Cell Carcinoma: A Narrative Review on Contemporary Diagnosis and Management
2022, Oncology and TherapyMOC-31 Antibody Immunolabeling During Mohs Surgery
2022, Dermatologic Surgery
Funding sources: None.
Conflicts of interest: None declared.
Reprints not available from the authors.