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口腔基底样鳞状细胞癌:一例报告并重点强调组织病理学诊断标准。

Oral basaloid squamous cell carcinoma: A case report with emphasis on histopathological diagnosis criteria.

机构信息

School of Dentistry, Tiradentes University, Aracaju, Sergipe, Brazil.

School of Dentistry, State University of Paraíba, Campina Grande, Paraíba, Brazil.

出版信息

Oral Oncol. 2022 Apr;127:105814. doi: 10.1016/j.oraloncology.2022.105814. Epub 2022 Mar 10.

DOI:10.1016/j.oraloncology.2022.105814
PMID:35279544
Abstract

Basaloid squamous-cell carcinoma (BSCC) is an uncommon variant of squamous cell carcinoma (SCC) consisting of atypical squamous and basaloid cells. It is an aggressive lesion that most commonly affects the oropharynx, being rare in intraoral sites. In this paper, we report the case of a male patient, 42 years old, smoker and chronic drinker, presenting a vegetating and ulcerated leukoerythroplastic lesion, asymptomatic, with five months of evolution, located on the floor of the mouth. Bilateral infarction of the submandibular lymph nodes was observed. Having established the presumptive diagnosis of SCC, an incisional biopsy was performed, which revealed a proliferation of nests and trabeculae of atypical basaloid and squamous cells. Immunohistochemical analysis revealed positivity for AE1/AE3, CK 5, CK 14, p63 and Ki67 (>80%), but negativity for CK7, S-100 and α-SMA. The diagnosis was BSCC. The patient was referred to a head and neck surgery and oncology service for definitive treatment, but died five months after diagnosis. BSCC is a clinicopathological entity whose diagnosis can be challenging. Its aggressive clinical behavior reiterates the relevance of the correct diagnosis for instituting the appropriate treatment. Thus, it is intended, in this work, to discuss the histopathological criteria for differential diagnosis of BSCC, aiming to contribute to its better knowledge and, perhaps, understanding.

摘要

基底样鳞状细胞癌(BSCC)是一种不常见的鳞状细胞癌(SCC)变体,由非典型鳞状细胞和基底样细胞组成。它是一种侵袭性病变,最常影响口咽,在口腔内罕见。本文报告了 1 例 42 岁男性患者,有吸烟和酗酒史,表现为增生性和溃疡性白色红斑病变,无症状,病程 5 个月,位于口底。观察到双侧颌下淋巴结梗死。在确立 SCC 的推测诊断后,进行了切开活检,显示出不典型基底样和鳞状细胞的巢和小梁状增生。免疫组织化学分析显示 AE1/AE3、CK5、CK14、p63 和 Ki67(>80%)阳性,但 CK7、S-100 和 α-SMA 阴性。诊断为 BSCC。患者被转介到头颈外科和肿瘤学服务机构进行确定性治疗,但在诊断后 5 个月死亡。BSCC 是一种临床病理实体,其诊断具有挑战性。其侵袭性临床行为再次强调了正确诊断对实施适当治疗的重要性。因此,本工作旨在讨论 BSCC 的鉴别诊断的组织病理学标准,旨在促进对其更好的认识和理解。

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