Histological Features
In histological examination, BCC is characterized by clusters of atypical basal cells. These cells typically have large, oval nuclei and scant cytoplasm. The tumor cells form nests or cords, which often show a peripheral palisading arrangement, meaning the cells at the periphery of these nests line up in a parallel fashion. Between these nests, there is often a stromal reaction, with mucinous alteration or a fibromyxoid stroma.Types of Basal Cell Carcinoma
There are several histological subtypes of BCC, each with distinct features: Nodular BCC: The most common type, characterized by well-defined nodules of basaloid cells.
Superficial BCC: Presents as superficial nests of tumor cells that often connect to the epidermis.
Infiltrative BCC: Shows more aggressive growth with thin, infiltrative strands of tumor cells.
Micronodular BCC: Composed of small, tightly packed nests of cells.
Diagnosis
The diagnosis of BCC is usually confirmed through a
biopsy and histopathological examination. In microscopy, special stains and immunohistochemical markers such as
Ber-EP4 can be used to differentiate BCC from other skin lesions.
Clinical Correlation
Clinically, BCC typically presents as a pearly or waxy bump, often with visible blood vessels (telangiectasias). It is most commonly found in sun-exposed areas of the skin, such as the face, ears, neck, and hands. Despite its potential for local invasion, BCC rarely metastasizes.Treatment
Treatment options for BCC include surgical excision, Mohs micrographic surgery, cryotherapy, and topical treatments. The choice of treatment depends on the size, location, and subtype of the tumor, as well as the patient's overall health.Prognosis
With appropriate treatment, the prognosis for BCC is generally excellent. However, patients with a history of BCC have a higher risk of developing additional lesions and should undergo regular skin examinations.Prevention
Preventive measures include avoiding excessive sun exposure, using sunscreen, and wearing protective clothing. Regular skin checks are also important for early detection and treatment of new lesions.
