Shai A, Halevy S, Grunwald M H, Manna H, Rothem A
Department of Dermatology Soroka Medical Center, PO Box 151, Beer-Sheva 84101, Israel.
Eur J Dermatol. 1999 Jan-Feb;9(1):35-8.
Transition from solar keratosis (SK) to squamous cell carcinoma (SCC) is well known and vastly documented. The possible relation between SK and basal cell carcinoma (BCC) is rarely mentioned in the dermatopathological literature. In order to identify the characteristics of the relation between SK and BCC, 40 slides of the head and neck regions in which both SK and BCC had been diagnosed, were retrieved from a collection in the Institute of Pathology of Beilinson Medical Center, seen between 1984 and 1994. Gradual and continuous transition between SK and BCC was found in 15 (37.5%) of these 40 slides. In order to estimate the prevalence of this phenomenon, 73 additional slides, which had been diagnosed as BCC of the head and neck, were re-examined. Atypia of the spinous layer, as an initial marker for the development of SK, was sought in each slide. Revision revealed spinous layer atypia in 26 (35.6%) slides, in addition to the previously diagnosed BCC. In seven (9.6%) the transition between atypical spinous cells and BCC was gradual and continuous. A gradual and continuous transition between SK and BCC can be explained by the presence of pluripotent stem cells in the epidermis. Stem cells, following malignant transformation, may differentiate in different directions, resulting in both SK and BCC.
日光性角化病（SK）向鳞状细胞癌（SCC）的转变已为人熟知且有大量文献记载。而SK与基底细胞癌（BCC）之间的可能关系在皮肤病理学文献中鲜有提及。为了明确SK与BCC之间关系的特征，从贝林森医学中心病理学研究所1984年至1994年间的藏品中检索出40张同时诊断出SK和BCC的头颈部区域切片。在这40张切片中，有15张（37.5%）发现SK与BCC之间存在渐进性和连续性转变。为了评估这种现象的发生率，对另外73张已诊断为头颈部BCC的切片进行了重新检查。在每张切片中寻找棘层异型性，作为SK发生发展的初始标志物。复查发现，除了先前诊断的BCC外，26张（35.6%）切片存在棘层异型性。在7张（9.6%）切片中，非典型棘细胞与BCC之间存在渐进性和连续性转变。SK与BCC之间的渐进性和连续性转变可以通过表皮中多能干细胞的存在来解释。干细胞在发生恶性转化后，可能会向不同方向分化，从而导致SK和BCC的产生。
