Skin nonmelanocytic tumor
Carcinoma (nonadnexal)
Acantholytic squamous cell carcinoma
Authors: Ghassan A. Tranesh, M.D., Hong Qu, M.D.
Topic Completed: 1 November 2014
Minor changes: 15 October 2020
Copyright: 2002-2020, PathologyOutlines.com, Inc.
PubMed Search: Acantholytic squamous cell carcinoma [title] skin
Table of Contents
Definition / general | Sites | Case reports | Gross description | Gross images | Microscopic (histologic) description | Microscopic (histologic) images | Positive stains | Electron microscopy description | Differential diagnosisCite this page: Tranesh GA, Qu H. Acantholytic squamous cell carcinoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/skintumornonmelanocyticadenoidscc.html. Accessed October 20th, 2020.
Definition / general
- Adenoid squamous cell carcinoma (SCC) is an uncommon histopathological variant of SCC characterised by acantholysis of tumor cells, creating pseudolumina and the appearance of glandular differentiation (J Clin Pathol 2006;59:1206)
- Also called pseudoglandular, pseudoangiosarcomatous, or acantholytic squamous cell carcinoma
- Does NOT appear to be more aggressive than SCC (Dermatol Surg 2011;37:353)
- Due to a desmosomal defect that causes lack of cell adhesion (acantholysis)
Sites
- Usually sun-exposed skin, often associated with actinic keratosis with acantholysis
Case reports
- 40 year old man with pseudovascular adenoid squamous cell carcinoma of oral cavity (J Oral Maxillofac Pathol 2012;16:288)
- 57 year old woman with adenoid squamous carcinoma of vulva (Int J Gynecol Pathol 2008;27:288)
- 73 year old woman with adenoid squamous cell carcinoma of oral cavity (Int J Clin Exp Pathol 2012;5:442)
Gross description
- Up to 1.5 cm, somewhat elevated (Int J Clin Exp Pathol 2012;5:442)
Gross images
Images hosted on other servers:
Excised exophytic polypoid growth
Resected tumor and mandible
Microscopic (histologic) description
- Invasive, tubular or pseudoglandular pattern of polygonal cells in dermis, with glassy eosinophilic cytoplasm and focal squamous pearl formation
- Usually connected to overlying epidermis (J Cutan Pathol 1989;16:114)
- Oral tumors may show pseudovascular morphology (J Clin Pathol 2006;59:1206)
Microscopic (histologic) images
Images hosted on other servers:
Tubular structures
Pseudoglandular pattern
Carcinoma cells proliferate in cords
Various stains
Cytokeratin+, CD34-
Hyaluronic acid+
Positive stains
- Both squamous cell component and adenoid component may be positive for CK5/6, p63, CEA, Ca19-9, MUC1, and KIT (Int J Clin Exp Pathol 2012;5:442)
Electron microscopy description
Images hosted on other servers:
Surface epithelial cells with microvillous processes
No intracytoplasmic vacuoles
Differential diagnosis
- Adenocarcinoma: primary or metastatic
- Adenosquamous carcinoma: adenocarcinoma element is positive for mucins
- Angiosarcoma
