Kanitakis Jean, Ducroux Emilie, Hoelt Pauline, Cahen Rémi, Jullien Denis
Departments of Dermatology, and.
Nephrology and Transplantation Immunology, Ed. Herriot Hospital Group, Lyon, France.
Am J Dermatopathol. 2018 Aug;40(8):e115-e118. doi: 10.1097/DAD.0000000000001146.
Basal-cell carcinoma with matrical differentiation (BCC-MD) is one of the rarest pathologic variants of basal-cell carcinoma, of which 41 cases have been so far reported in detail. One of them developed in a heart-transplant recipient. We report a new case of BCC-MD occurring in a renal-transplant recipient and review the relevant literature. A 75-year-old white man who had received a renal allograft 7 years ago developed a tumor on the left temple clinically suggestive of basal-cell carcinoma. Microscopically, the tumor associated features typical of basal-cell carcinoma (basaloid lobules with peripheral palisading and clefting) and pilomatricoma (presence of shadow/ghost cells). The 2 tumor components expressed variably beta-catenin, HEA/Ber-EP4, CD10, PHLDA-1, MIB-1/Ki67, calretinin, and bcl-2. BCC-MD has no distinctive clinical features. It affects predominantly male patients with a mean age of 69 years. More than half of cases appear on the head/neck area. Some cases harbor CTNNB1 mutations. Differential diagnosis includes tumors with matrical differentiation, namely pilomatrix carcinoma. The outcome is usually favorable after surgical excision, although regional lymph node metastases developed in 2 patients.
具有毛母质分化的基底细胞癌（BCC-MD）是基底细胞癌最罕见的病理变体之一，迄今为止仅有41例详细报道。其中1例发生在心脏移植受者身上。我们报告1例发生在肾移植受者身上的BCC-MD新病例，并复习相关文献。1名75岁白人男性，7年前接受了肾移植，左颞部出现1个临床上提示为基底细胞癌的肿瘤。显微镜下，肿瘤具有基底细胞癌的典型特征（基底样小叶伴外周栅栏状排列和裂隙形成）和毛母质瘤（出现影细胞/幽灵细胞）。这2种肿瘤成分β-连环蛋白、HEA/Ber-EP4、CD10、PHLDA-1、MIB-1/Ki67、钙视网膜蛋白和bcl-2的表达各不相同。BCC-MD没有独特的临床特征。它主要影响平均年龄69岁的男性患者。超过半数的病例出现在头颈部区域。部分病例存在CTNNB1突变。鉴别诊断包括具有毛母质分化的肿瘤，即毛母质癌。手术切除后预后通常良好，不过有2例患者出现了区域淋巴结转移。
