What’s the molecules telling?

65 year old male presented with non healing ulcer over the pinna of right ear for 5 months. A biopsy from the lesion was done and following is the report.

  • Carcinoma with basaloid features and pigmentation – biopsy right pinna.
  • Immuno staining: P63 – diffuse strong positivity. P40 – diffuse moderate positivity. BerEP4 – negative.
Keratocanthoma
Malignant Melanoma
Squamous cell carcinoma
Basal cell carcinoma

Explanation

Based on the histopathology report, the most probable diagnosis is squamous cell carcinoma.

  • p40 & P63 are molecular markers sensitive and specific for SqCC.
  • BerEP4 is a monoclonal antibody which is used as a marker of BCC. It works by detecting the EpCAM antigen, a transmembrane epithelial glycoprotein cell adhesion molecule found in humans. BerEP4 is made from human mammary as well as mice carcinoma cell lining (MCF-7).

References

  1. Anthony Paulo Sunjaya, Angela Felicia Sunjaya, and Sukmawati Tansil Tan, “The Use of BEREP4 Immunohistochemistry Staining for Detection of Basal Cell Carcinoma,” Journal of Skin Cancer, vol. 2017, Article ID 2692604, 10 pages, 2017.
  2. https://www.pathologyoutlines.com/topic/stainsdeltaNp63.html

Meet the author

Dr Sanu P Moideen is an Indian-born oto-rhino-laryngologist (ENT) based in Cochin, Kerala, India. He is currently working as Post-Doctoral Fellow in Head and Neck Oncology at Regional Cancer Center, Trivandrum, Kerala.

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