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Background and Design: The literature does not include sufficient data on the associations between cytological atypia and stromal reactions\udin basal cell carcinoma (BCC) subtypes. The aim of the study was to evaluate the grade of cytological atypia and to determine the associations\udbetween atypia grade and stromal reactions in BCC.\udMaterials and Methods: The study included 85 BCC patients. Clinical parameters including age, gender and lesion location were evaluated. As\udhistopathological parameters; subtype (high risk/low risk), grade of cytological atypia (mild/moderate/severe), density of peritumoral/adjacent\udperivascular inflammation, presence of lymphoid follicle formation, and the stromal reaction type (fibromyxoid/desmoplastic) were evaluated.\udResults: The mean age of the patients was 67.93±11.46 years (range: 38-88) and the female to male ratio was 45:40. 54.1% of the lesions\udwere located on high-risk regions and high-risk subtype was observed in 50.6% of the lesions. Severe cytological atypia was associated with\udhigh-risk subtype (p<0.001), dense peritumoral/perivascular inflammation (p<0.001), and desmoplastic stroma (p<0.001). Moderate/severe\udatypia, desmoplastic stroma, dense peritumoral/perivascular inflammation and lymphoid follicle formation were significantly more common\udin high-risk subtypes (p<0.001). Locations were not associated with aytpia grades, density of peritumoral/perivascular inflammation, lymphoid\udfollicle formation, and stromal reactions (p=0.774, p=0.665, 0.416, 0.230, 0.461, and 1, respectively).\udConclusion: Severe cytological atypia in BCC was associated with more intense inflammation, desmoplastic stroma and high-risk subtypes\udin BCC. In conclusion, cytological atypia grade may be a factor influencing stromal reactions. Thus, evaluating the atypia grade in routine\udhistopathological examination of BCCs might be used to identify high-risk BCC subtypes with more infiltrative potential

The correlation of cytological atypia and stromal reaction in basal cell carcinoma