Acantholytic Variant Research Articles

Multiple squamous cell carcinomas of temporal bone years after radiotherapy for malignancy glottis-report of a rare case with review of literature

Larynx is unique in its anatomy. It is critical to map the lesions accurately so that the patient may benefit from the strategy most likely to preserve a functional larynx with the lowest likelihood of recurrence and the least morbidity. We describe a case of 60-year-old male with malignancy glottis diagnosed at the age of 43, treated with external beam radiotherapy, presented 15 years after with swelling in the right upper part of the face, lateral to the eye. Radiological investigations suggested neoplasm in the skin over the right zygomatic part of the temporal bone. Biopsy confirmed malignancy, basal cell carcinoma type. Wide local excision of the lesion with split skin grafting was done. After 2 years, he presented with right ear pain, discharge, and hard of hearing. Examination and radiological investigations confirmed a mass in the external auditory canal, infiltrating through the temporal bone. Biopsy revealed an acantholytic variant of squamous cell carcinoma (SCC). The patient was advised about treatment options and radiotherapy was chosen. Further, a literature search was conducted to detect similar cases. We describe the incidence and prevalence of radiation-induced temporal bone malignancy, an exceedingly rare and late complication of head and neck irradiation. Radiation induced SCCs are highly malignant secondary neoplasms in the head and neck region. It constitutes a therapeutic challenge because of its anatomy and the known side effects of radiation. Timely intervention with a multidisciplinary approach is necessary.

Acantholytic variant of seborrheic keratoses: Uncommon histological feature

Seborrheic keratoses are common benign cutaneous neoplasms. Here we report a case because of the peculiar histological appearance characterized by acantholysis. An elderly woman presented with gradually progressive keratotic nodular growth over her thigh. Although the basic histologic findings suggestive of seborrheic keratosis like papillomatosis, acanthosis, hyperkeratosis, presence of horn pseudocyst and squamous eddies were present with upper layers of epidermis showed focal spongiosis and acantholysis. Differentiation with acantholytic dyskeratotic acanthoma, warty dyskeratoma, acantholytic actinic keratosis could be made on histological features. Although the histogenesis is uncertain, it seems that acantholytic variant is a rare variant of irritated seborrheic keratosis.

An acantholytic variant of dowling degos disease

Galli- Galli disease is a rare acantholytic variant of Dowling- Degos disease, with few cases reported in the literature till date. We here, describe an interesting case of Galli- Galli disease with prominent histopathological findings. Future studies and genotype-phenotype correlations may elucidate why acantholysis is observed in some patients, but not in others.

33984 A rare genodermatosis with an unusual presentation: A case of Galli-Galli

Introduction: Galli-Galli disease (GGD), a rare acantholytic variant of Dowling-Degos disease (DDD), is a genodermatosis characterized by progressive, reticulate, pigmented lesions of intertriginous and flexural sites. We present a unique case of GGD that spared the intertriginous areas and histologically mimicked seborrheic keratosis. Results: A 53-year-old female with a history of mild hidradenitis suppurativa (HS) presented with a pruritic rash of greater than 5-year duration. Physical examination was notable for innumerable well-defined, reticulated, erythematous to light brown papules and macules on the bilateral upper and lower extremities. The patient’s father and sister had similar lesions. Previous biopsies showed features of seborrheic keratosis or Grover disease. Repeat biopsy demonstrated slight papillated epidermal hyperplasia with elongation of rete ridges. A focus of acantholysis in the epidermis was noted in deeper sections. Histopathologic and clinical features could represent Galli-Galli disease. Treatment with triamcinolone 0.1% ointment did not alleviate the pruritus; the patient was started on a trial of halobetasol 0.01 %/tazarotene 0.045%. Conclusion: GGD is inherited in an autosomal dominant fashion with a mutation in the KRT5 gene, resulting in disruption of basal keratinocyte integrity. A subset of GGD cases has been reported in non-classical sites and does not carry the KRT5 mutation; the distribution of this case fits this unusual subset. Rarely, as with the current case, GGD is associated with HS along with mutations in the gamma-secretase complex and POFUT1 genes. This case highlights a nonclassical case of GGD, its rare association with HS, and salient clinical and histologic diagnostic features.

Acantholytic squamous cell carcinomas of the cervix: A case series

Squamous cell carcinoma of the uterine cervix is considered the most common histologic variant of cervical cancer, with well-established treatment protocols and prognosis. An infrequent histologic variant of cervical squamous cell carcinoma is the acantholytic variant (ASCC), which is characterized by discohesive cells that result in a pseudoglandular and/or angiomatoid pattern of growth. This variant of squamous cell carcinoma has been regarded as having a poor prognosis at certain anatomic sites such as the head and neck and vulva. In the uterine cervix, the importance of this variant has not been yet established. A ten-year retrospective review of squamous cell carcinoma of the uterine cervix was performed to identify this variant and correlate it with clinical characteristics to better define its prognostic implications. During the study period 19 cases were identified containing from 10 to 80% acantholytic component. Mean age at diagnosis was 49 years. Clinical stages were 1A2 (1 case), Ib1 (16), and IIA1 (2). Median follow-up was 92 months. When compared with controls, ASCC were larger in size (1.4 vs 3.5 cm), had deeper involvement of the cervical stroma (21 vs 47%), had more lymph node metastasis (8 vs 26%), more frequent recurrences (4 vs 15%) and a shorter disease-free survival; however, no statistical differences were identified in overall survival. ASCC is an infrequent variant of cervical cancer which seems to have an impact on disease-free survival but no in overall survival.

Vulvar squamous cell carcinoma associated with Equus caballus papillomavirus type 2 infection in a Japanese mare

Equus caballus papillomavirus type 2 (EcPV2) infection has been associated with genital squamous cell carcinoma (SCC) development in horses. However, very few reports on EcPV2-associated disease in Asia exist. Our study characterizes pathological and virological features of an EcPV2-associated vulvar SCC from a Japanese mare. Conventional PCR, in situ hybridization, reverse-transcriptase PCR and immunohistochemistry confirmed the presence and distribution of EcPV2 within the lesion and suggested that p53 degradation may not be the mechanism by which this virus induces neoplastic transformation. The complete viral sequence in this Japanese case shows near perfect sequence homology with European reference strains of EcPV2, which may be useful when considering the target for future EcPV2 vaccine development. This report also serves to highlight the importance of EcPV2 in female (vulvar) neoplasia, which is less commonly recognized than EcPV2-induced male (penile or preputial) neoplasia. Finally, the SCC described in this mare was an unusual acantholytic variant that has not been reported previously in horses. It is the first report of EcPV2 identified from genital SCC in Asia and underscores the likely worldwide distribution of this virus and its consistent association with equine genital neoplasia.

Acantholytic squamous cell carcinoma: Pathological study of three cases in Ecuador

<p>Adenoid squamous cell carcinoma is an uncommon histopathological variant of squamous cell carcinoma characterized by acantholysis of tumor cells creating pseudolumina and the appearance of glandular differentiation. It is also known as pseudoglandular, pseudoangiosarcomatous, adenoid, epithelioma dyskeratoticum, or adenoacanthoma. In this article, we describe and analyze three cases of acantholytic cell carcinoma. The purpose is to verify if the data of our cases can be validated with scientific information. All our cases presented lesions in the face, and in one of them the developed tumor on the skin showed actinic keratosis. The other two tumors were located in the right side of the face, and both were big: the bigger tumor was approximately 8 × 4 cm and the other one with a size of 6 × 2.5 cm. Due to the size and location, they were both send to the oncologist for treatment. One of our cases showed metatypical carcinomas accompanied by acantholytic variant of squamous cell carcinoma. None of our cases presented metastasis. The histopathological finding were keratinized squamous tumor cell type, adenoid structures with round spaces with a defined wall of at least one-cell width, and spaces with isolated or group of dyskeratotic cells.</p>

A sneak peep at adenoid /acantholytic variant of oral squamous cell carcinoma

A sneak peep at adenoid /acantholytic variant of oral squamous cell carcinoma

Involvement of Markers D2-40, Cd10 and F-Actin in Squamous Cell Carcinoma Invasion of the Tongue

In recent decades, an increase in the incidence of lingual squamous carcinoma, especially among young people, has been seen to be the most common form of oral cancer. In addition, this localization appears to be one of the most aggressive forms of oral squamous carcinoma, being highly locally invasive, with early metastasis, with a high rate of relapse and with a survival rate of 5 years being below 60%. To explain this phenotype, recent studies have shed light on the molecular mechanisms underlying lingual carcinogenesis, including loco-regional invasiveness with the study of markers involved in this process. From this perspective, our study proposed the investigation of the reactivity of markers D2-40, CD10 and F-actin in 57 squamous carcinomas of the tongue diagnosed in various stages, and we selected cases from the Archives of the Pathological Anatomy Laboratory of the County Emergency Hospital of Craiova (SCJUCraiova) during the years 2015-2017. The immunohistochemical technique used was that of detecting the LSAB enzyme, and the evaluation of tumor immunoreactivity was done using the semi-quantitative score described by Remmele and Stegner. Tumor reactivity was present mainly in moderately differentiated forms, usually periferic of the proliferation, in the invasion front, more intense in the acantholytic variant. On the opposite side there were cases of well differentiated squamous carcinoma, which obtained the lowest immunoreactivity scores. Reactivity was also present at the stromal level, especially in cases involving a desmoplastic reaction and inflammatory stroma cases, respectively. The pattern of predominant reactions at the periphery of the proliferation and the interface with the inflammatory or desmoplastic stroma proves the adoption by these neoplastic cells of a more aggressive phenotype with their successive involvement in local invasion and metastasis. Therefore, the markers used have prognostic value identifying the most aggressive forms of lingual squamous carcinoma thus allowing a therapeutic stratification of these patients who will benefit from a molecular targeting therapy. Keywords: tongue, squamous cell carcinoma, invasiveness, CD10, D2-40, F-actin

Acantholytic and Pagetoid Variant of Bowen's Disease with Microinvasion on the Scalp of a Young Female Patient: A Case Report.

Bowen’s disease (BD) is a non-melanoma skin cancer with several histological subtypes. Herein we describe a case of a 35-year-old woman with a 4-cm diameter crusted plaque on the parietal scalp region. She had the lesion for 2 years. It had previously been histologically diagnosed as pemphigus vulgaris and only treated with a topical cream. The lesion progressively became thicker and larger. A new biopsy showed atypical cell proliferation through the whole thickness of the epidermis and follicular epithelium, with dermal microinvasion along with acantholysis and clear cell formation. The patient underwent total lesion excision (1 cm margin) with the diagnosis of both acantholytic and pagetoid subtypes of BD and dermal microinvasion. We describe a rare case of a young female patient with both subtypes of BD present in one lesion on an area not exposed to the sunlight. The lesion was initially misdiagnosed as pemphigus vulgaris.

Two cases of Galli-Galli disease – An acantholytic variant of Dowling-Degos disease

Galli-Galli disease (GGD) is thought to be a rare acantholytic variant of the genodermatosis Dowling-Degos disease (DDD) with less than 30 cases reported in the literature. Here we present two cases with clinicopathologic features suggestive of Gali-Gali disease.

Acantholytic squamous cell carcinoma: Pathological study of three cases in Ecuador

<p>Adenoid squamous cell carcinoma is an uncommon histopathological variant of squamous cell carcinoma characterized by acantholysis of tumor cells creating pseudolumina and the appearance of glandular differentiation. It is also known as pseudoglandular, pseudoangiosarcomatous, adenoid, epithelioma dyskeratoticum, or adenoacanthoma. In this article, we describe and analyze three cases of acantholytic cell carcinoma. The purpose is to verify if the data of our cases can be validated with scientific information. All our cases presented lesions in the face, and in one of them the developed tumor on the skin showed actinic keratosis. The other two tumors were located in the right side of the face, and both were big: the bigger tumor was approximately 8 × 4 cm and the other one with a size of 6 × 2.5 cm. Due to the size and location, they were both send to the oncologist for treatment. One of our cases showed metatypical carcinomas accompanied by acantholytic variant of squamous cell carcinoma. None of our cases presented metastasis. The histopathological finding were keratinized squamous tumor cell type, adenoid structures with round spaces with a defined wall of at least one-cell width, and spaces with isolated or group of dyskeratotic cells.</p>

Prominent signet ring cell morphology in a pulmonary squamous cell carcinoma

In daily practice, signet ring cell morphology immediately brings to the mind the possibility of an adenocarcinoma at first glance. The signet ring cell appearance has been described and is well-known in a wide variety of some other neoplasms as well. Surprisingly however, neoplastic cells having the same morphology can unexpectedly be encountered in not previously well-documented tumors. Here, we present an 85-year-old man diagnosed with primary pulmonary squamous cell carcinoma and a large signet ring cell population. Examination of the lobectomy specimen and further radiological workup was consistent with stage I disease. Signet ring cell variant of squamous cell carcinoma is a very infrequent tumor and has been reported in only eight cases from skin, cervical and oral cavity biopsies as well as in one case of pulmonary acantholytic variant of squamous cell carcinoma with focal signet ring cells. To be aware of this entity is crucial for pathologists to reach the correct diagnosis, particularly in cytological samples, because of its potentially modifying effect on treatment options and patient management compared to adenocarcinomas. Our patient remained in clinical remission during the 9-month follow-up.

Acantholytic squamous cell carcinoma of the tongue: A diagnostic challenge

Squamous cell carcinoma is the commonest malignancy encountered in the head and neck. However, certain variants of this tumor can pose diagnostic dilemma due to their morphological mimicry. An incisional biopsy taken from a growth over the tongue presented with a similar diagnostic challenge. The unique histomorphological features of the rare acantholytic variant of squamous cell carcinoma and its differential diagnosis have been addressed in this report.

Acantholytic Variant of Bowen's Disease with Micro-invasive Squamous Cell Carcinoma: A Case Report of a Unique Variant.

Bowen's disease is generally regarded as premalignant dermatoses. The disease affects both skin and the mucosa and has the potential to progress to invasive squamous cell carcinoma. There are descriptions of several histological variants of Bowen's disease like psoriasiform, atrophic, pagetoid, etc. Acantholysis of anaplastic keratinocytes with bullae/cleft formation is described in premalignant condition like actinic keratosis and adenoid variant of squamous cell carcinoma, but there is lack of report describing this phenomena in Bowen's disease. We present a case of unusual acantholytic variant of Bowen's disease with focus of micro-invasive carcinoma.

Galli-Galli disease is an acantholytic variant of Dowling-Degos disease: Additional genetic evidence in a German family

Galli-Galli disease is an acantholytic variant of Dowling-Degos disease: Additional genetic evidence in a German family

Galli-Galli Disease: A Rare Acantholytic Variant of Dowling-Degos Disease

Galli-Galli disease is a rare acantholytic variant of Dowling-Degos disease, with few cases reported in the literature. We describe a case of Galli-Galli disease and review the literature.

Acantholytic variant of squamous cell carcinoma of the breast

Acantholytic variant of squamous cell carcinoma (AVSCC) of the breast typically has pseudoglandular or pseudoangiosarcomatous histopathologic features due to marked dyscohesiveness of tumor cells which have dense squamoid cytoplasm. Tumor cells show immunoexpression for cytokeratin AE1/AE3, high molecular weight cytokeratin and p63, thus pertaining squamous characteristics. We present a typical case of AVSCC of the breast with preoperative metastasis to a sentinel lymph node and one-time recurrence. The tumor was predominantly composed of acantholytic component with minor contribution of patternless spindle cell component. Multifocal intraductal carcinomas were found within the tumor. Although some reports had mentioned about other breast cancers focally showing these characteristic features in usual invasive ductal carcinomas or metaplastic carcinomas, only nine cases have been collected as this recently defined entity since 1986. It is suggested that this tumor would be more aggressive than usual invasive ductal carcinomas based on the original report of three cases. However, additional cases of AVSCC often did not show dismal prognostic outcome. We present a typical case of AVSCC of the breast without critical progression of the disease for 38 months.

Galli-Galli Disease Presenting as Lichenoid Papules in the Flexures

Galli-Galli disease is a rare genodermatosis currently regarded as an acantholytic variant of Dowling-Degos disease. The 2 diseases have the same clinical features: reticular hyperpigmented macules in the great skin folds, erythematous scaly papules and plaques, comedo-like lesions, and pitted perioral scars, and the only differentiating characteristic is the histological finding of acantholysis, usually without dyskeratosis. We describe the case of a patient with hyperpigmented papules in the skin folds as the only sign of Galli-Galli disease, and we present a review of the literature.

Presentación de enfermedad de Galli-Galli como pápulas liquenoides flexurales

Galli-Galli disease is a rare genodermatosis currently regarded as an acantholytic variant of Dowling-Degos disease. The 2 diseases have the same clinical features: reticular hyperpigmented macules in the great skin folds, erythematous scaly papules and plaques, comedo-like lesions, and pitted perioral scars, and the only differentiating characteristic is the histological finding of acantholysis, usually without dyskeratosis. We describe the case of a patient with hyperpigmented papules in the skin folds as the only sign of Galli-Galli disease, and we present a review of the literature.