Does the panel of cytokeratin 20 and androgen receptor antibodies differentiate desmoplastic trichoepithelioma from morpheaform/infiltrative basal cell carcinoma?

Terrence M. Katona, Susan Perkins, Steven D. Billings

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Abstract

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.

Original languageEnglish
Pages (from-to)174-179
Number of pages6
JournalJournal of Cutaneous Pathology
Volume35
Issue number2
DOIs
StatePublished - Feb 2008

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Keratin-20
Basal Cell Carcinoma
Androgen Receptors
Antibodies

ASJC Scopus subject areas

  • Dermatology
  • Pathology and Forensic Medicine

Cite this

@article{e3e0f101fb4846bd85af6d031a3271b6,
title = "Does the panel of cytokeratin 20 and androgen receptor antibodies differentiate desmoplastic trichoepithelioma from morpheaform/infiltrative basal cell carcinoma?",
abstract = "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 M{\"e}rkel 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.",
author = "Katona, {Terrence M.} and Susan Perkins and Billings, {Steven D.}",
year = "2008",
month = "2",
doi = "10.1111/j.1600-0560.2007.00783.x",
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volume = "35",
pages = "174--179",
journal = "Journal of Cutaneous Pathology",
issn = "0303-6987",
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number = "2",

}

TY - JOUR

T1 - Does the panel of cytokeratin 20 and androgen receptor antibodies differentiate desmoplastic trichoepithelioma from morpheaform/infiltrative basal cell carcinoma?

AU - Katona, Terrence M.

AU - Perkins, Susan

AU - Billings, Steven D.

PY - 2008/2

Y1 - 2008/2

N2 - 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.

AB - 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.

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U2 - 10.1111/j.1600-0560.2007.00783.x

DO - 10.1111/j.1600-0560.2007.00783.x

M3 - Article

VL - 35

SP - 174

EP - 179

JO - Journal of Cutaneous Pathology

JF - Journal of Cutaneous Pathology

SN - 0303-6987

IS - 2

ER -