Basal cell carcinoma with neuroendocrine differentiation 

Case 677  17.1.13 (H. Diwan)  M 79 chronic leg wound 

Some LP views missing.  Infiltrative BCC pattern with adjacent mucin.  Chromogranin stain +ve. 

Case 2426    17.10.19 (S. Taibjee)  F 70 cheek lesion     

Looked like secondary from carcinoma 

BerEP4 strong +ve; CD56 +ve; chromogranin patchy +ve 

EMA, synaptophysin, CK20, TTF-1, CK7, Cam 5.2 all –ve 

BCC with NE differentiation has good prognosis 

Case 2656  10.9.20  (S. Taibjee)  M 91 cheek 

LP BCC architecture.  However, palisading is not well seen and there is no retraction artefact.  Some cells show bubbly cytoplasm.  I suspected this was a BCC mimic such as sebaceous carcinoma or basaloid SCC.  S. Taibjee makes the point that the nuclei are larger and “high grade” compared to common BCC.  He feels these may be more common than recognised and often signed out as ordinary BCC.  They don’t seem to have a propensity for metastasis  i.e. don’t behave like MCC. 

IH: showed strong BerEP4, chromogranin and CD56. Pronounced lymphocytic infiltrate as far down as the fat was reactive and not a sign of other pathology such as CLL. 

Case 2751 21.1.21  (S. Taibjee) F 84 lesion behind ear 

Epidermally derived cords and strands suggesting porocarcinoma.  Areas of more typical BCC including retraction artefact contrasting with a 'high grade' cytology. 

BerEP4 +ve; EMA -ve; neuroendocrine markers CD56, synaptophysin and chromogranin +ve. CK20-ve. Some do express CAM5.2, but without dot positivity 

Ref: Review: Neuroendocrine differentiation of skin tumours.  

Hamie, L et al . Am J Derm Path Dec 2020 42: (12), p 899–910 

Case 2816  22.4.21 (S. Taibjee)  M elderly 

Ulcerated BCC pattern with cytology suggesting neuroendocrine differentiation.  Confrmed by IH:  BerEP4+ve; EMA -ve; CK20 -ve; chromogranin and synaptophysin +ve.