We report a case of metatypical basal cell carcinoma on the nose of a 79-year-old woman with a brief review of the literature. Report Of A Case A 79-year-old woman presented with a painless lesion on her nose. The lesion was roughly oval with focal gray discoloration and a slightly raised central portion. She reported no other associated symptoms and denied having other similar skin lesions. Her past medical history was otherwise unremarkable.On microscopic examination of the submitted shave biopsy, the lesion showed skin with a loosely circumscribed dermal proliferation of lobules of epitheliod cells. Nuclear enlargement with chromatin clumping with or without macronucleoli, and a moderate amount of eosinophilic cytoplasm was present. Most prominent were few numbers of haphazardly placed giant cells with no associated foreign bodies or granulomas. The overlying epithelium was atrophic with focal parakeratosis. There was no direct connection between the epidermis and the atypical dermal proliferation, and no clefting was identified. The mitotic activity was approximately 1-2 mitoses per high power field (40x). Multiple immunohistochemical stains were performed which demonstrated positive staining for pancytokertatin (AE1:3), bcl-2, and BerEp4.
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