续上篇

Basal cell carcinoma vs. trichoblastoma (trichoepithelioma)

Immunopanel—BerEP4, CD10, Bcl-2, CD34, CK20, Cam5.2

In trichoblastomas, CD10 typically highlights the peritumoral stroma, including papillary mesenchymal bodies, with minimal patchy staining of basaloid cells. In contrast, in BCC, the stroma is negative and basaloid cells variably strongly positive with CD10. Diffuse Bcl-2 positivity is reported in BCC, whereas the basal layer alone is highlighted in TE. The authors have found this to be variable and unreliable in practice. CD34 may highlight the peritumoural stroma in the desmoplastic variant of TE and not in infiltrative BCC, but this is also an unreliable finding in the authors’ experience. Merkel cells can be highlighted with Cam5.2 or CK20 and are absent from BCC but increased in number in trichoblastoma.

 突击学习，本例形态学集中在基底细胞癌和毛母细胞瘤的鉴别。这两种瘤形态学相似，老师就其鉴别诊断的免疫组化分析提出问题，就BerEP4可以做为基底细胞肿瘤和鳞状细胞癌鉴别的重要marker，但是在基底细胞癌和毛母细胞瘤（Modern Pathology (2008) 21, 178–185; doi:10.1038/modpathol.3801000; published online 7 December 2007，57% of desmoplastic trichoepithelioma）中都有表达，

明天在学习继续写

 BerEP4在汗腺和外毛鞘发生的肿瘤也可阳性，但毛鞘表达BerEP4不如在BCC表达的强。

本例主要是区分BCC和毛母。

谢谢Dr,djdnx.