Article

P63 immunohistochemistry in the distinction of adenoid cystic carcinoma from basaloid squamous cell carcinoma

Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA.
Modern Pathology (Impact Factor: 6.36). 06/2005; 18(5):645-50. DOI: 10.1038/modpathol.3800329
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ABSTRACT Morphologic distinction of high-grade adenoid cystic carcinoma from basaloid squamous cell carcinoma can be difficult. Equivocal diagnoses can mislead treatment. We have investigated the possibility that immunohistochemical staining for the presence of p63, a novel epithelial stem-cell regulatory protein, could be a useful means of distinguishing these two neoplasms. Archival, routinely processed slides were subjected to citrate-based antigen retrieval, exposure to anti-p63 monoclonal 4A4, and developed with a streptavidin-biotin kit and diaminobenzidine as chromogen. p63 was detected in 100% of the adenoid cystic carcinomas (n=14) and 100% of basaloid squamous cell carcinomas (n=16). Basaloid squamous cell carcinomas consistently displayed diffuse p63 positivity, with staining of nearly 100% of tumor cells. In contrast, adenoid cystic carcinoma displayed a consistently compartmentalized pattern within tumor nests. Compartmentalization was manifested in two patterns: (1) selective staining of a single peripheral layer of p63-positive cells surrounding centrally located tumor cells that were p63-negative and (2) tumor nests consisting of multiple contiguous glandular/cribriform-like units of p63-positive cells surrounding or interspersed with p63-negative cells. p63 immunostaining constitutes a specific and accurate means of distinguishing adenoid cystic carcinoma from basaloid squamous cell carcinoma. p63 positivity in adenoid cystic carcinoma appears to be homologous to that seen in the basal and/or myoepithelial compartments of salivary gland and other epithelia, and may signify a stem-cell-like role for these peripheral cells. Diffuse p63 positivity in basaloid squamous cell carcinoma suggests dysregulation of p63-positive stem cells in poorly differentiated squamous carcinoma.

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    • "The majority of adenoid cystic carcinomas show positive immunoreactivity for smooth muscle actin, but this marker is negative in BSCC (11). Moreover, p63 is diffusely expressed in the basaloid cells of BSCC, while this protein is only observed in the peripheral cells of adenoid cystic carcinoma (12). In addition, perinuclear dot-like vimentin expression is characteristic of BSCC, in contrast to the diffuse cytoplasmic expression of adenoid cystic carcinoma (11). "
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    ABSTRACT: Basaloid squamous cell carcinoma (BSCC) is a rare variant of squamous cell carcinoma. The occurrence of BSCC in the nasal cavity is extremely rare. In the present study, two cases of BSCC occurring in the maxillary sinus are reported and the clinicopathological features and immunohistochemical characteristics of this rare tumor are discussed. Two patients, aged 85 (case 1) and 60 years (case 2), presented with nasal tumors and persistent nasal obstruction. In each case, the biopsy or resected specimen of the maxillary sinus tumor revealed an infiltrative proliferation of solid epithelial nests composed of basaloid cells exhibiting hyperchromatic nuclei without conspicuous nucleoli and scant cytoplasm. Mitotic figures were frequently observed and spherical hyalinized materials were present within the tumor nests. Immunohistochemically, the tumor cells exhibited diffuse positive immunoreactivity for p63 and perinuclear dot-like positivity for vimentin, leading to a final diagnosis of BSCC of the maxillary sinus. Furthermore, it was demonstrated for the first time in the two cases that cathepsin K, a cysteine protease with marked collagenolytic and elastolytic activities, was expressed in a diffuse manner. One patient (case 2) succumbed to multiple metastases, while the other (case 1) remains alive with the disease. In conclusion, it was demonstrated that cathepsin K was immunopositive in two cases of BSCC of the maxillary sinus and that it may be involved in tumor invasion by this highly aggressive carcinoma.
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    • "Expression of MMP-1, MMP-2 and MMP-9 were reported higher in cells of BSCC than in cells of squamous cell carcinoma, suggesting of aggressive behaviour. Emanuel et al.[32] have stressed the value of p63 in making the distinction between BSCC and adenoid cystic carcinoma of head and neck. "
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    ABSTRACT: Basaloid squamous cell carcinoma (BSCC) is a rare distinct histologic variant of squamous - cell carcinoma of the head and neck region. BSCC is more aggressive and has a poorer prognosis, although histologically, it is associated with squamous cell carcinoma and squamous atypia. The usual site of occurrence for BSCC is the upper aerodigestive tract, floor of the mouth and base of the tongue. This is a case report of an unusual case of BSCC of retromolar trigone, which is quite rare.
    Journal of Oral and Maxillofacial Pathology 04/2011; 15(2):192-196. DOI:10.4103/0973-029X.84495
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