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The Histopathologic Differentiation of Keratoacanthoma and Squamous Cell Carcinoma of the Skin
Author(s) -
KERN WILLIAM H.,
McCRAY MICHAEL K.
Publication year - 1980
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/j.1600-0560.1980.tb01202.x
Subject(s) - keratoacanthoma , pleomorphism (cytology) , pathology , basal cell , keratin , medicine , anaplasia , dermatopathology , lesion , atypia , epidermoid carcinoma , immunohistochemistry
The classification of skin tumors as keratoacanthoma or squamous cell carcinoma may be difficult and, albeit rarely, lesions classified as keratoacanthoma do metastasize. In order to review the reproducibility of the pathologic classification, 100 keratoacanthomas and 100 squamous cell carcinomas of the skin were randomized and reclassified. In 81% of the keratoacanthomas and 86% of the squamous carcinomas the original diagnosis was confirmed. The presence or absence of 10 histologic criteria was recorded for all cases. Almost all of the confirmed keratoacanthomas had invaginating keratin‐filled craters with epidermal proliferation at the sides and the bottom of the lesion and significant atypia and mitotic activity was rare. Most of the confirmed squamous cell carcinomas showed considerable cellular anaplasia and pleomorphism and many displayed significant mitotic activity. It is concluded that a definite diagnosis of keratoacanthoma or squamous cell carcinoma can be made objectively on histologic grounds but that some tumors are atypical or borderline lesions which must be indicated in the pathologic report.