Differential expression of PHLDA1 (TDAG51) in basal cell carcinoma and trichoepithelioma
ABSTRACT Background A recent small series demonstrated perfect sensitivity and specificity utilizing immunostaining for PHLDA1, a marker of follicular stem cells, in the distinction of desmoplastic trichoepithelioma and morphoeiform basal cell carcinoma (BCC) in small biopsy specimens. Objectives To assess this result more broadly. Methods We performed immunoperoxidase staining of BCCs (superficial n = 16, nodular n = 15, micronodular n = 15, infiltrative n = 17, morphoeiform n = 16, infundibulocystic n = 14) and trichoepitheliomas (conventional n = 19, desmoplastic n = 16) with PHLDA1. Results Morphoeiform BCCs typically lacked PHLDA1 staining (88% demonstrated no staining and 12% of cases had staining in < 25% of the tumour), while in contrast 74% of classical and 88% of desmoplastic trichoepitheliomas demonstrated strong PHLDA1 staining in over half of the tumour. However, micronodular BCCs demonstrated focal to diffuse positive staining in a third of the cases. Conclusions Based upon our staining results, we discuss the biological significance of PHLDA1 expression and the limits in its diagnostic utility.
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ABSTRACT: Context .- Immunohistochemistry is not a diagnostic test but a highly valuable tool that requires interpretation within a context. Objective .- To review the current status and limitations of immunohistochemistry in dermatopathology. Data Sources .- English-language literature published between 1980 and 2014. Conclusions .- Although immunohistochemistry is rarely completely specific or sensitive, it is an important adjunctive technique in dermatopathology and can be helpful in a series of diagnostic dilemmas.Archives of pathology & laboratory medicine 01/2015; 139(1):83-105. DOI:10.5858/arpa.2014-0075-RA · 2.88 Impact Factor
Article: TrichoblastomasAnnales de Dermatologie et de Vénéréologie 08/2014; 141(8-9). DOI:10.1016/j.annder.2014.06.001 · 0.67 Impact Factor
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ABSTRACT: Context.-Because the skin and modified mucosal surfaces of the vulvar region contain dense apocrine glands and anogenital mammary-like glands, in addition to eccrine glands and folliculosebaceous units, benign as well as malignant lesions derived from these adnexal structures are, not surprisingly, found in the vulva. However, their incidence occurring in the vulva has not been reported, to our knowledge. Objective.-To determine the incidence of various vulvar adnexal lesions. Design.-We performed a retrospective review (1978-2010) of the cases at our institution. Results.-A total of 189 vulvar adnexal lesions were identified. Most of these lesions were benign (133 of 189; 70%), with hidradenoma papilliferum being the most common, followed by syringoma and various types of cysts. Rare cases of tubular adenoma, poroma, spiradenoma, hidradenoma, cylindroma, sebaceoma, and trichoepithelioma were identified. Malignant adnexal neoplasms comprised the remaining 30% (56 of 189) of the cases. Extramammary Paget disease was the most common (49 of 56), and 29% (14 of 49) demonstrated an invasive component. Rare cases of basal cell carcinoma, sebaceous carcinoma, apocrine carcinoma, adenoid cystic carcinoma, and spiradenocarcinoma were identified. Conclusions.-In this retrospective review, we identified several benign entities that have not been previously reported on the vulva, namely pilomatricoma, poroma, spiradenoma, and sebaceoma. Hidradenoma papilliferum and extramammary Paget disease were the most common benign and malignant adnexal neoplasms, respectively. The spectrum of various vulvar adnexal lesions appears to reflect the frequency of the underlying glandular elements.Archives of pathology & laboratory medicine 09/2013; 137(9):1237-46. DOI:10.5858/arpa.2012-0434-OA · 2.88 Impact Factor