Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Hoang, Mai P.; Dresser, Karen; Kapur, Payal; High, Whitney A.; Mahalingam, Meera

doi:10.1038/modpathol.3801000

Cited by 98 publications

(89 citation statements)

References 43 publications

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“…25,26 Our own experience indicates that CK15 expression may be seen in desmoplastic trichoepithelioma, basal cell carcinoma (only the nodular and keratotic subtypes), and microcystic adnexal carcinoma with understandably enough, negative expression in squamous cell carcinoma. 16,24 More recently, we have also found strong CK15 expression in benign adnexal neoplasms, such as chondroid syringoma, hidradenoma papilliferum, apocrine hidrocystoma, and cylindroma/spiradenoma (unpublished data, MM, MPH).…”

Section: Discussionmentioning

confidence: 98%

“…14 CK15 expression was reported in follicular neoplasm, 23 microcystic adnexal carcinoma, 24 apocrine mixed tumors of the skin, and other benign neoplasms with apocrine differentiation. 25,26 Our own experience indicates that CK15 expression may be seen in desmoplastic trichoepithelioma, basal cell carcinoma (only the nodular and keratotic subtypes), and microcystic adnexal carcinoma with understandably enough, negative expression in squamous cell carcinoma.…”

Section: Discussionmentioning

confidence: 99%

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The diagnostic utility of immunohistochemistry in distinguishing primary skin adnexal carcinomas from metastatic adenocarcinoma to skin: an immunohistochemical reappraisal using cytokeratin 15, nestin, p63, D2-40, and calretinin

et al. 2010

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Often the distinction of primary adnexal carcinoma from metastatic adenocarcinoma to skin from breast, lung, and other sites can be a diagnostic dilemma. Current markers purportedly of utility as diagnostic adjuncts include p63 and D2-40; however, their expression has been demonstrated in 11-22% and 5% of metastatic cutaneous metastases, respectively. Both cytokeratin (CK) 15 and nestin have been reported as follicular stem cell markers. We performed CK15 and nestin, as well as previously reported stains (such as p63, D2-40, and calretinin) on 113 cases (59 primary adnexal carcinomas and 54 cutaneous metastases). Expressions of p63, CK15, nestin, D2-40, and calretinin were observed in 91, 40, 37, 44, and 14% of primary adnexal carcinoma, respectively, and in 8, 2, 8, 4, and 10% of cutaneous metastases, respectively. p63 appeared to be the most sensitive marker (with a sensitivity of 91%) in detecting primary adnexal carcinomas. CK15 appeared to be the most specific marker with a specificity of 98%. Using v 2 analysis, statistically significant P-values (o0.05) were observed for p63, CK15, nestin, and D2-40 in the distinction of primary adnexal carcinoma versus cutaneous metastases. In logistic regression and stepwise selection for predicting a primary adnexal carcinoma, statistical significance was observed for p63, CK15, and D2-40 (P-values: o0.001, 0.0275, and 0.0298, respectively) but not for nestin (P-value ¼ 0.4573). Our study indicates that diagnostic sensitivity and specificity are significantly improved using a selected panel of immunohistochemical markers, including p63, CK15, and D2-40. Positive staining with all three markers argues in favor of a primary cutaneous adnexal neoplasm.

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Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

The diagnostic utility of immunohistochemistry in distinguishing primary skin adnexal carcinomas from metastatic adenocarcinoma to skin: an immunohistochemical reappraisal using cytokeratin 15, nestin, p63, D2-40, and calretinin

et al. 2010

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“…86,90 In addition, CK15 stains positive in MAC and is negative in mBCC. 86,90 Reports are mixed regarding whether a subset of MACs may express Ber-Ep4, 53,91,92 and MACs may express p75NTR. 71 …”

Section: Microcystic Adnexal Carcinomamentioning

confidence: 99%

Histologic Mimics of Basal Cell Carcinoma

Stanoszek

Wang

Harms

2017

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Basal cell carcinoma (BCC) is the most common human malignant neoplasm and is a frequently encountered diagnosis in dermatopathology. Although BCC may be locally destructive, it rarely metastasizes. Many diagnostic entities display morphologic and immunophenotypic overlap with BCC, including nonneoplastic processes, such as follicular induction over dermatofibroma; benign follicular tumors, such as trichoblastoma, trichoepithelioma, or basaloid follicular hamartoma; and malignant tumors, such as sebaceous carcinoma or Merkel cell carcinoma. Thus, misdiagnosis has significant potential to result in overtreatment or undertreatment. Objective.— To review key features distinguishing BCC from histologic mimics, including current evidence regarding immunohistochemical markers useful for that distinction. Data Sources.— Review of pertinent literature on BCC immunohistochemistry and differential diagnosis. Conclusions.— In most cases, BCC can be reliably diagnosed by histopathologic features. Immunohistochemistry may provide useful ancillary data in certain cases. Awareness of potential mimics is critical to avoid misdiagnosis and resulting inappropriate management.

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“…The immunohistochemical CK20 marker for Merkel cells is nearly always immunopositive for DTE, but rarely or never for syringoma (7). DTE is also negative for carcinoembryonic antigen (26,27) compared with syringoma, which shows a positive reaction in the luminal cells. The most common features that may aid in differentiating DTE from syringoma are listed in Table I.…”

Section: A B C D Ementioning

confidence: 96%

Desmoplastic trichoepithelioma: A clinicopathological study of three cases and a review of the literature

et al. 2015

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Abstract. Desmoplastic trichoepithelioma (DTE) is a rare benign adnexal tumor with the characteristic features of asymptomatic, solitary, annular, indurated and centrally depressed papules or plaques, most commonly occurring in younger individuals on the face. Microscopically and clinically, DTE may be difficult to distinguish from other cutaneous adnexal neoplasms, particularly syringoma, cutaneous metastatic breast cancer, morpheaform basal cell carcinoma and microcystic adnexal carcinoma. The present study reports three cases of DTE. The first case was of a 45-year-old male with an asymptomatic flesh-colored plaque below the right edge of the outer canthus that had been present for seven years. The second case was of a 23-year-old female with an asymptomatic skin lesion on the right cheek that had slowly and progressively increased in size. The third case was of a 26-year-old female who presented with a hard yellowish-white plaque, which gradually grew and formed a rectangular, 3x4-cm patch, on the tip of the left brow. This plaque was present for three years without evident cause or subjective symptoms. In all three cases, the routine systemic examinations and laboratory findings were normal. Histopathological and immunohistochemical findings from incisional biopsies of the lesions were consistent with a diagnosis of DTE. DTE treatment methods and immunohistochemical markers were analyzed by reviewing clinical pathological aspects in order to avoid a misdiagnosis and to provide the best available treatment approach for DTE.

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Microcystic adnexal carcinoma: an immunohistochemical reappraisal

Cited by 98 publications

References 43 publications

The diagnostic utility of immunohistochemistry in distinguishing primary skin adnexal carcinomas from metastatic adenocarcinoma to skin: an immunohistochemical reappraisal using cytokeratin 15, nestin, p63, D2-40, and calretinin

The diagnostic utility of immunohistochemistry in distinguishing primary skin adnexal carcinomas from metastatic adenocarcinoma to skin: an immunohistochemical reappraisal using cytokeratin 15, nestin, p63, D2-40, and calretinin

Histologic Mimics of Basal Cell Carcinoma

Desmoplastic trichoepithelioma: A clinicopathological study of three cases and a review of the literature

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