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Amyloid deposition has been observed in tissue specimens of basal cell carcinomas. A 68-year-old man with a nodular basal cell carcinoma on his left arm near the elbow is described; microscopic evaluation of the biopsy tissue specimen shows not only nodular aggregates and strands of atypical basaloid tumor cells but also marked deposition of amorph...
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... examination of the hematoxylin and eosin-stained tissue specimen showed strands and nodular aggregates of atypical basaloid tumor cells in the dermis reaching the deep margin of biopsy; the overlying epidermis was thin with effacement of the rete ridges and sparse overlying orthokeratosis (Figure 2). Deposition of amorphous material filled the dermal stroma between the tumor aggregates ( Figure 3); the amount of amyloid present was abundant (+++). The lateral aspect of the specimen showed solar elastosis in the upper dermis above the tumor and below the epidermis ( Distant (a) and closer (b) views of the biopsy specimen show marked deposition of amyloid, presenting amorphous material in the dermal stroma between the tumor aggregates (solid black stars) (hematoxylin and eosin: a, x 4; b, x 10). ...
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Citations
... Less-aggressive BCC subtypes, such as nodular BCC, have been reported to be up to 85% positive for amyloid deposition [3]. ...
... Amyloid and mucin deposition are commonly observed in less-aggressive BCC subtypes, such as nodular BCC (up to 85% positive for amyloid) [3]. Our findings confirmed the presence of amyloid through in vivo RCM in 28 of the 31 lesions, all of which were non-aggressive. ...
Basal cell carcinoma (BCC) is the most common keratinocyte carcinoma and the most prevalent skin cancer in humans, worldwide. BCC is histologically characterized by the proliferation of basaloid cells, arranged in globular masses of varying size, often separated from the surrounding stroma by optically empty spaces. Although attributed to tumor retraction during tissue processing for the preparation of pathology slides, these spaces are also seen on cryostat sections. The aim of this study is to in vivo characterize amyloid and mucin deposits in primary BCC lesions through RCM, followed by histopathological correlation. We included twenty-two consecutive subjects totaling thirty-one primary BCCs. Each lesion underwent the same evaluation protocol which included: clinical and dermoscopic images, RCM imaging, excisional biopsy under local anesthesia, and histopathological examination (colloidal iron and cytokeratin 34betaE12 stains). Hypo-reflective peritumoral clefts and hyper-reflective globules were measured on RCM images and compared to mucin and amyloid deposits seen on histology slides. The mean differences between RCM and histology measurements in both mucin and amyloid were not statistically significant. There were medium and strong correlations between RCM and histology regarding mucin and amyloid deposits, respectively.
... Mikhail and Mehregan reviewed 10,000 biopsies of seborrheic keratosis and found 14 cases to be associated with basal cell carcinoma [9]. Boyd Amyloidosis has frequently been described as a basal cell carcinoma-associated MUSK IN A NEST [14]. However, we are not aware of lichen amyloidosis coexisting at the same site as another cutaneous condition. ...
A collision tumor is a neoplastic lesion comprised of two or more tumors consisting of distinct cell populations in the concurrent location. Multiple skin neoplasms at one site (MUSK IN A NEST) is a term recently coined to describe two or more cutaneous benign or malignant tumors occurring at the same anatomic site. In retrospective studies, seborrheic keratosis and cutaneous amyloidosis have both individually been documented as a component of a MUSK IN A NEST. This report describes a 42-year-old woman who presented with a pruritic skin condition on her arms and legs of 13 years' duration. Skin biopsy results showed epidermal hyperplasia with hyperkeratosis, hyperpigmentation of the basal layer with mild acanthosis, and evidence of amyloid deposition in the papillary dermis. Based on the clinical presentation and pathology findings, a concurrent diagnosis of macular seborrheic keratosis and lichen amyloidosis was established. A MUSK IN A NEST consisting of a macular seborrheic keratosis and lichen amyloidosis is likely a more common occurrence than implied by the paucity of published cases of this phenomenon.
... Human kPLCA has a higher incidence in women than in men, 5,21 and basal-cell carcinoma-associated human kPLCA is more common in elderly patients. 7 Similarly, we found that the incidence of amyloid deposition in female dogs was 1.9 times higher than that in male dogs (albeit without statistical significance) and identified aging as a risk factor for amyloid deposition. Therefore, sex and aging are associated with the pathogenesis of cutaneous keratinic amyloid deposition in both humans and dogs. ...
Keratinic primary localized cutaneous amyloidosis is a disease in humans; however, no similar condition has been reported in animals. This study aimed to investigate cutaneous keratinic amyloid deposition in dogs and elucidate its etiology. Canine hair follicle tumor tissues were histopathologically analyzed. Immunohistochemistry and mass spectrometry-based proteomic analyses were performed to identify precursor protein candidates. Structural prediction and in vitro fibrillization analyses were conducted to determine the amyloidogenic region and gene sequencing analysis was performed to assess mutations. Of the 266 samples, 16 had amyloid deposition. Amyloid deposits were found in the stroma of tumors and in the margins of keratin debris and around normal hair follicles. Cytokeratin 5 (CK5) was identified as a precursor protein candidate. C-terminal truncation of CK5 was observed in amyloid deposits, and the truncation sites varied depending on the deposition pattern. There was a significantly higher incidence of amyloid deposition in Shiba dogs, and CK5 amino acid polymorphisms were identified in these dogs. A part of the C-terminal region of both canine and human CK5 exhibited highly amyloidogenic properties in vitro. This study revealed the existence of cutaneous keratinic amyloid deposition in animals and identified CK5 as an amyloid precursor protein, providing novel insights into understanding the etiology of cutaneous amyloidosis.
... In addition, benign tumors and malignant neoplasms can have associated secondary amyloidosis in the adjacent dermis (Figure 1). The source of the AA amyloidosis protein is from keratinocytes [30,31]. ...
... However, investigators have speculated that the data may have been skewed by studies with lower observed incidences that only evaluated hematoxylin and eosin-stained sections instead of tissue sections also stained with reagents to specifically detect amyloid. Hence, the incidence of BCC associated with amyloid may be higher, ranging from 51% to 75% (with a calculated incidence of 64%), [31][32][33][34]. ...
... Nodular BCC was the most common tumor subtype and superficial BCC was the least frequent tumor subtype. Solar elastosis was also often present in the dermis [31]. ...
Basal cell carcinoma (BCC) can be a component of a collision tumor in which the skin cancer is present at the same cutaneous site as either a benign tumor or a malignant neoplasm. However, BCC can also concurrently occur at the same skin location as a non-neoplastic cutaneous condition. These include autoimmune diseases (vitiligo), cutaneous disorders (Darier disease), dermal conditions (granuloma faciale), dermal depositions (amyloid, calcinosis cutis, cutaneous focal mucinosis, osteoma cutis, and tattoo), dermatitis, miscellaneous conditions (rhinophyma, sarcoidal reaction, and varicose veins), scars, surgical sites, systemic diseases (sarcoidosis), systemic infections (leischmaniasis, leprosy and lupus vulgaris), and ulcers. The relationship between the BCC and the coexisting non-neoplastic condition may be coincidental or possibly related to the development of the BCC; alternatively, the development of the BCC may be unrelated to the coexisting non-neoplastic conditions and secondary to either a Koebner isomorphic response or a Wolf isotopic response in an immunocompromised district of skin. This paper reviews several of the case reports and studies that describe the association of BCC with these non-neoplastic cutaneous conditions.
... Amyloid and intratumoral mucin deposition are frequently observed in less-aggressive nodular BCCs (up to 85% positive for amyloid). 4 Our findings confirmed presence of amyloid and mucin in all cases; of these 87.5% were non-aggressive. Thus, non-invasive visualization of prominent amyloid and mucin features may be clinically relevant for diagnosis of less-aggressive BCCs, which in turn can help streamline management. ...
