Acantholytic Squamous Cell Carcinoma In Upper Aerodigestive Tract: Histomorphology, Immunohistochemical Profile And Epithelial Mesenchymal Transition Phenotype Change | 3109
Journal of Clinical & Experimental Pathology
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quamous cell carcinoma (SCC) is the most common epithelial malignancy in the upper aerodigestive tract. Acantholytic
SCC (ASCC) arising from aerodigestive mucosa is a rare variant of SCC. Histomorphologically, ASCC may lose the typical
features of SCC and mimic other epithelial or mesenchymal malignancies due to advanced acantholysis and dyskeratosis.
Because of its rarity, information of prognosis, pathologic features and immunohistochemical profiles is limited. We have studied
clinicopathologic features and immunohistochemical profiles of four ASCCs arising from upper aerodigestive tract. Clinical
results indicated aggressive biologic behavior with high rate of recurrence. One of four patients showed lymph node metastasis
at the time of biopsy and died of disease in seven months after treatment. Morphologically, all tumors revealed significant
acantholysis with separation of tumor cells or intratumoral spaces. The tumor cells were highly pleomorphism. Large giant
tumor cells, spindle cells and variable growth patterns were noted. In immunohistochemical study, all tumor cells revealed
positive reactions for AE1/AE3 and p63 indicating squamous epithelial origin. Different from conventional aerodigestive SCC,
ASCC showed significant reductions of cytokeratin19, E-cadherin and concomitant up-regulation of vimentin expression. Both
morphologic characteristics and immunohistochemical features indicate ASCC has acquired epithelial mesenchymal transition
(EMT) phenotype. However, different from other solid malignant tumors, EMT phenotype change in ASCC is not limited at the
invasive front of the tumor peripheral zone but rather diffusely involves entire lesion. CK19 would be an insensitive marker for
following up and in detecting disseminated tumor cells in patients with ASCC in upper aerodigestive tract.
Xin Gu, MD. Associate professor in Department of Pathology, Louisiana State University Health Sciences Center in Shreveport, Louisiana. Dr. Gu is trained in Anatomic and Clinical Pathology between 1996 and 2001 at LSUHSC-Shreveport. He is currently a tenured associate professor of pathology specialized in surgical pathology and renal pathology at LSUHSC-Shreveport
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