| Epidermal Non Melanocytic Neoplasms Pathologymindmap.com |
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Epidermal Lesions
Actinic Keratosis
Sunlight damage related
Most commonly hypertrophic form
Alternating ortho & parakaratosis
Cytologic atypia (not full thickness)
Increased cytologic atypia in Bowenoid variant
Basal Cell CA (BCC)
Mostly head and neck
Pallasading-like basal cell aggregates
Clefting artifact (in formalin fixed tissue)
Sclerosing Variant
Desmoplastic
Morphea-like
Basolid Variant
More aggressive
Bowenoid papulosis
Anogenital region
Condiloma acuminatum-like
Assoc. w/ HPV-16
Full thickness cytologic atypia
Usually spontaneously regress
Keratoacanthoma
Rapid growth
Early phase
Lacks keratinization
Full-blown phase
Dome-shaped mass
Keratin filled crater
Overhanging edges
Pushing borders
Late phase
Lichenoid infiltrate
Cytologic atypia & mitosis same as well diff. SCC
Frequent eosinophils
DDx
SCC (infrequent eosinophils)
Seborrheic keratosis
Lesion above the level of adjacent normal epidermis
Usually acanthotic
Increase in basal-like keratinocytes
Horny pseudocyts
Squamous cell CA (SCC)
cytologic atypia
invasive
Expresses Ulex europaeus
(absent in BCC)
Adenoid variant
Acantholytic (pseudoglandular)
Spindle cell Variant
Usually on lips
Sun-exposed areas
DDx: Melanoma & Atypical Fibroxanthoma
Squamous cell CA in situ (Bowen’s)
Full thickness cytologic atypia
Intact basement membrane
Erythroplasia
Bowen’s of Glans penis, vulva, & oral mucosa
More invasive nature
Actinic Keratosis
Sunlight damage related
Most commonly hypertrophic form
Alternating ortho & parakaratosis
Cytologic atypia (not full thickness)
Increased cytologic atypia in Bowenoid variant
Basal Cell CA (BCC)
Mostly head and neck
Pallasading-like basal cell aggregates
Clefting artifact (in formalin fixed tissue)
Sclerosing Variant
Desmoplastic
Morphea-like
Basolid Variant
More aggressive
Bowenoid papulosis
Anogenital region
Condiloma acuminatum-like
Assoc. w/ HPV-16
Full thickness cytologic atypia
Usually spontaneously regress
Keratoacanthoma
Rapid growth
Early phase
Lacks keratinization
Full-blown phase
Dome-shaped mass
Keratin filled crater
Overhanging edges
Pushing borders
Late phase
Lichenoid infiltrate
Cytologic atypia & mitosis same as well diff. SCC
Frequent eosinophils
DDx
SCC (infrequent eosinophils)
Seborrheic keratosis
Lesion above the level of adjacent normal epidermis
Usually acanthotic
Increase in basal-like keratinocytes
Horny pseudocyts
Squamous cell CA (SCC)
cytologic atypia
invasive
Expresses Ulex europaeus
(absent in BCC)
Adenoid variant
Acantholytic (pseudoglandular)
Spindle cell Variant
Usually on lips
Sun-exposed areas
DDx: Melanoma & Atypical Fibroxanthoma
Squamous cell CA in situ (Bowen’s)
Full thickness cytologic atypia
Intact basement membrane
Erythroplasia
Bowen’s of Glans penis, vulva, & oral mucosa
More invasive nature