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Diagnostic accuracy of immunohistochemical markers in differentiation between basal cell carcinoma and trichoepithelioma in small biopsy specimens
Author(s) -
Mostafa Naglaa A.,
Assaf Magda,
Elhakim Sami,
AbdelHalim Mona R. E.,
ElNabarawy Eman,
Gharib Khaled
Publication year - 2018
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/cup.13305
Subject(s) - trichoepithelioma , immunohistochemistry , pathology , basal cell carcinoma , biopsy , basal (medicine) , carcinoma , differential diagnosis , medicine , stromal cell , anatomical pathology , biology , basal cell , insulin
Background The distinction of trichoepithelioma from basal cell carcinoma in small superficial biopsies is important but often challenging. This has inspired many scientists to test the validity of immunohistochemical markers in the differential diagnosis. Objectives To develop an immunohistochemical protocol that helps in differentiation between both trichoepithelioma (TE) and basal cell carcinoma (BCC) with higher sensitivity and specificity. Methods Using standard immunohistochemical techniques, we examined 10 TEs and 19 BCCs for the expression of CK19, Ki‐67, androgen receptors (AR), CD10, and PHLDA1. Results Immunoreactivity of AR, Ki‐67, and CD10 in tumor cells was significantly higher in BCC than TE with a diagnostic accuracy in BCC of 75.5%, 75.8%, and 79.3% respectively, whereas immunoreactivity of PHLDA1 in tumor cells and stromal CD10 was significantly higher in TE than BCC with a diagnostic accuracy in TE of 100% and 82.8%, respectively. In contrast, immunoreactivity for CK19 showed no statistically significant differences between both tumors. Conclusion The analysis of CD10, Ki‐67, and PHLDA1 can be used as a helpful immunohistochemical panel in the distinction between TE and BCC especially in small and superficial biopsies.