TY - JOUR
T1 - A diagnostic pitfall; small cell carcinoma-like features in basaloid squamous cell carcinoma of the esophagus
AU - Ishida, Hirotaka
AU - Kasajima, Atsuko
AU - Yamauchi, Takuro
AU - Akaishi, Ryujiro
AU - Ueki, Shunsuke
AU - Taniyama, Yusuke
AU - Fujishima, Fumiyoshi
AU - Koike, Tomoyuki
AU - Kamei, Takashi
AU - Lam, Alfred King Yin
AU - Sasano, Hironobu
N1 - Funding Information:
Ise, Ms. Erina Iwabuchi, Mr. Katsuhiko Ono, and Ms. Yasuko Furukawa (Tohoku University, Miyagi, Japan) for their excellent technical support. Conflict of interest statement. The authors have no conflicts of interest to disclose. Funding. This work was supported in part by the Manfred Stolte-Stiftung (to A.K). Ethics approval. The study protocol was approved by the ethics committee of our institution (Accession number of Tohoku University Hospital 2018–1–151). Consent to participate/for publication. Informed consents were obtained from all patients for participating and publication. Authors’ contributions. The conception of the study was designed by Hirotaka Ishida and Atsuko Kasajima. Material preparation was performed by Hirotaka Ishida, Takuro Yamauchi, Ryujiro Akaishi, Shunsuke Ueki and Fumiyoshi Fujishima. Immunohistochemical staining was performed by Hirotaka Ishida, Atsuko Kasajima, Takuro Yamauchi, Ryujiro Akaishi and Shunsuke Ueki. Hirotaka Ishida, Atsuko Kasajima, Fumiyoshi Fujishima and Hironobu Sasano evaluated morphological features of the neoplasms examined in this study and the results of immunohistochemistry. Data collection was performed by Hirotaka Ishida, Takuro Yamauchi, Ryujiro Akaishi, Shunsuke Ueki, Yusuke Taniyama, Tomoyuki Koike and Takashi Kamei. The data was analyzed by Hirotaka Ishida and Atsuko Kasajima. Hironobu Sasano, Takashi Kamei and Alfred King-Yin Lam supervised the project. The first draft of the manuscript was written by Hirotaka Ishida and Atsuko Kasajima, and all authors commented on the manuscript. Manuscript editing was performed by all authors. All authors approved the final version of the manuscript.
Publisher Copyright:
© 2023, Histology and Histopathology. All rights reserved.
PY - 2023/2
Y1 - 2023/2
N2 - Esophageal basaloid squamous cell carcinoma may resemble small cell carcinoma biopsy specimens and cause difficulties in pathology diagnosis. We aimed to clarify the clinicopathological significance of small cell carcinoma-like morphologies in basaloid squamous cell carcinoma. Thirty biopsy specimens of esophageal basaloid squamous cell carcinoma were reviewed and compared with 13 matched surgical specimens. Small cell carcinoma-like features, such as diffuse growth, nuclear molding, or nuclear crush artifact, were identified in 80% (24/30) of the biopsies and in 77% (10/13) of the surgery specimens, but in a proportionally much smaller area in the surgical specimens than in the biopsy samples. The presence of a small cell carcinoma-like feature had no impact on patients´ outcome. Immunohistochemically, synapto-physin and chromogranin A were consistently negative, while CD56 was expressed in 42% (10/24) of basaloid squamous cell carcinomas with small cell carcinoma-like features. p16, a highly sensitive marker for small cell carcinoma, was also expressed in 8% (2/24). p40 was expressed in all cases of basaloid squamous cell carcinoma. In conclusion, small cell carcinoma-like features are frequent and conspicuous in biopsies, which are probably caused by exogenous factors such as friction and external pressure that occur in biopsy procedure and in the tumor environment. Small cell carcinoma-like features may lead to a misinterpretation of a true small cell carcinoma, if CD56 is the only neuroendocrine marker expressed. p16 expression may also be detected in basaloid squamous cell carcinoma.
AB - Esophageal basaloid squamous cell carcinoma may resemble small cell carcinoma biopsy specimens and cause difficulties in pathology diagnosis. We aimed to clarify the clinicopathological significance of small cell carcinoma-like morphologies in basaloid squamous cell carcinoma. Thirty biopsy specimens of esophageal basaloid squamous cell carcinoma were reviewed and compared with 13 matched surgical specimens. Small cell carcinoma-like features, such as diffuse growth, nuclear molding, or nuclear crush artifact, were identified in 80% (24/30) of the biopsies and in 77% (10/13) of the surgery specimens, but in a proportionally much smaller area in the surgical specimens than in the biopsy samples. The presence of a small cell carcinoma-like feature had no impact on patients´ outcome. Immunohistochemically, synapto-physin and chromogranin A were consistently negative, while CD56 was expressed in 42% (10/24) of basaloid squamous cell carcinomas with small cell carcinoma-like features. p16, a highly sensitive marker for small cell carcinoma, was also expressed in 8% (2/24). p40 was expressed in all cases of basaloid squamous cell carcinoma. In conclusion, small cell carcinoma-like features are frequent and conspicuous in biopsies, which are probably caused by exogenous factors such as friction and external pressure that occur in biopsy procedure and in the tumor environment. Small cell carcinoma-like features may lead to a misinterpretation of a true small cell carcinoma, if CD56 is the only neuroendocrine marker expressed. p16 expression may also be detected in basaloid squamous cell carcinoma.
KW - Basaloid squamous cell carcinoma
KW - Biopsy
KW - Diagnostic pitfall
KW - Esophagus
KW - Small cell carcinoma
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UR - http://www.scopus.com/inward/citedby.url?scp=85148633469&partnerID=8YFLogxK
U2 - 10.14670/HH-18-497
DO - 10.14670/HH-18-497
M3 - Article
C2 - 35861388
AN - SCOPUS:85148633469
SN - 0213-3911
VL - 38
SP - 155
EP - 163
JO - Histology and Histopathology
JF - Histology and Histopathology
IS - 2
ER -