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Does the panel of cytokeratin 20 and androgen receptor antibodies differentiate desmoplastic trichoepithelioma from morpheaform/infiltrative basal cell carcinoma?
Author(s) -
Katona Terrence M.,
Perkins Susan M.,
Billings Steven D.
Publication year - 2008
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.1600-0560.2007.00783.x
Subject(s) - trichoepithelioma , immunophenotyping , pathology , cytokeratin , basal cell carcinoma , androgen receptor , medicine , immunohistochemistry , immunostaining , carcinoma , flow cytometry , basal cell , cancer , immunology , prostate cancer
Background: Evaluation of androgen receptor (AR) and cytokeratin 20 (CK20) expression can aid in distinguishing between conventional basal cell carcinoma (characteristically AR+, CK20−) and trichoepithelioma (frequently AR−, CK20+). Within these two groups of tumors, morpheaform/infiltrative basal cell carcinoma (mBCC) and desmoplastic trichoepithelioma (DTE) are particularly challenging to differentiate both clinically and histologically. We investigated whether AR and CK20 immunostains may distinguish between mBCC and DTE. Methods: Immunohistochemistry for AR and CK20 was performed on 15 DTEs and 31 mBCCs. Any immunoreactivity within the tumor for AR or CK20 was considered positive. Results: AR expression was seen in 13% (2/15) of DTE and 65% (20/31) of mBCC cases (chi‐square p = 0.0011). CK20‐positive Mërkel cells were identified in 100% (15/15) of DTE and 3% (1/31) of mBCC (chi‐square p < 0.0001). The expected pattern of AR−, CK20+ immunophenotype was present in 87% (13/15) of DTE cases. In mBCC, 61% (19/31) was AR+, CK20−. No DTE was AR+, CK20− and no mBCC was AR−, CK20+. Conclusions: Immunohistochemical stains for AR and CK20 are useful to differentiate DTE from mBCC. The AR−, CK20+ immunophenotype is sensitive (87%) and specific for DTE (100%). The AR+, CK20− immunophenotype is specific (100%) and moderately sensitive (61%) for mBCC.