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        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Although few cases of squamous cell carcinoma &#40;SCC&#41; with clear cells have been published&#44; we believe that these cells are often present in SCC&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We studied 249 SCCs&#44; analyzing a number of clinical and histological variables&#46; Various immunohistochemical techniques &#40;immunoperoxidase method&#41; were used to determine whether adnexal differentiation was present&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">There were 96 SCCs with a proportion of clear cells of over 25&#37;&#46; Advanced or established SCCs and SCCs associated with Bowen disease contained a larger proportion of clear cells&#46; We defined 2 histological patterns&#58; a&#41; clear cells around the keratin pearls of SCCs arising from pre-existing actinic keratosis and with indirect signs of human papilloma virus infection in hair follicles&#59; and b&#41; clear cells that simulate adnexal differentiation in lesions arising on pre-existing Bowen disease lesions&#46; There were also 19 carcinomas with true adnexal differentiation&#46;</p> <span class="elsevierStyleSectionTitle">Discussion</span><p class="elsevierStyleSimplePara elsevierViewall">Clear cells are frequently observed in SCC&#44; though large numbers of clear cells are present only in certain SCCs&#46; The appearance of clear cells in SCCs is progressive and they are only present in more advanced SCC&#46; The presence of clear cells is suggestive of adnexal differentiation&#59; however&#44; in the majority of cases&#44; their presence is due to infiltration of normal adnexal structures by the cells of pagetoid Bowen disease&#46; True adnexal differentiation exists only in a small percentage of cases &#40;7&#46;6&#37; in our study&#41;&#46; The histological pattern described as clear cells around keratin pearls practically rules out this differentiation&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p class="elsevierStyleSimplePara elsevierViewall">Se han publicado pocos casos de carcinoma espinocelular &#40;CE&#41; de c&#233;lulas claras&#44; aunque creemos que es frecuente observar c&#233;lulas claras en los CE&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p class="elsevierStyleSimplePara elsevierViewall">Hemos estudiado 249 CE&#46; Analizamos distintas variables cl&#237;nicas e histol&#243;gicas&#46; Hemos usado diversas t&#233;cnicas de inmunohistoqu&#237;mica &#40;m&#233;todo de inmunoperoxidasa&#41; para valorar si exist&#237;a diferenciaci&#243;n anexial&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Observamos 96 CE con m&#225;s de un 25&#37; de c&#233;lulas claras&#46; Existe m&#225;s cantidad de c&#233;lulas claras en los CE desarrollados o &#171;no incipientes&#187; y en los derivados de enfermedad de Bowen &#40;EB&#41;&#46; Describimos dos patrones histol&#243;gicos&#58; a&#41; c&#233;lulas claras alrededor de las perlas c&#243;rneas del CE&#44; que se asocia a la existencia de queratosis act&#237;nica como lesi&#243;n previa y a signos indirectos de virus del papiloma humano &#40;VPH&#41; en infund&#237;bulos pilosos&#44; y b&#41; c&#233;lulas claras que simulan diferenciaci&#243;n anexial&#44; relacionado con EB como lesi&#243;n previa&#46; Tambi&#233;n hemos encontrado 19 carcinomas con verdadera diferenciaci&#243;n anexial&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">Es frecuente observar c&#233;lulas claras en los CE&#44; aunque solo algunos presentan una gran cantidad&#46; El desarrollo de c&#233;lulas claras en los CE ser&#237;a progresivo y solo aparecer&#237;a en los CE m&#225;s desarrollados&#46; Cuando se observan c&#233;lulas claras en los CE&#44; se tiende a pensar que existe diferenciaci&#243;n anexial&#44; sin embargo&#44; en la mayor&#237;a de casos se tratar&#237;a solo de EB de c&#233;lulas claras que infiltra estructuras anexiales normales&#46; En un peque&#241;o porcentaje de casos &#40;7&#44;6&#37; en nuestro estudio&#41; s&#237; existe verdadera diferenciaci&#243;n anexial&#46; Por otra parte&#44; el patr&#243;n histol&#243;gico descrito como c&#233;lulas claras alrededor de perlas c&#243;rneas pr&#225;cticamente nos descartar&#237;a dicha diferenciaci&#243;n&#46;</p>"
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Vol. 100. Núm. 4.
Páginas 307-316 (mayo 2009)
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Vol. 100. Núm. 4.
Páginas 307-316 (mayo 2009)
Original articles
Acceso a texto completo
Clear Cells in Cutaneous Squamous Cell Carcinoma
Las Células Claras en el Carcinoma Espinocelular Cutáneo
Visitas
7819
R. Corbalán-Véleza,
Autor para correspondencia
raulcorb@gmail.com

Correspondence: Servicio de Dermatología, Hospital Universitario Virgen de la Arrixaca, Ctra. Murcia-Cartagena, s/n, 30120 El Palmar, Murcia, Spain.
, J.A. Ruiz-Maciab, C. Brufauc, J.M. López-Lozanod, E. Martínez-Barbae, F.J. Carapetod
a Servicio de Dermatología, Hospital Universitario Virgen de la Arrixaca Murcia, Spain
b Servicio de Anatomía Patológica, Hospital Vega Baja, Orihuela, Alicante, Spain
c Servicio de Dermatología, Hospital General Reina Sofía, Murcia, Spain
d Servicio de Medicina Preventiva, Hospital Vega Baja, Orihuela, Alicante, Spain
e Servicio de Anatomía Patológica, Hospital Universitario Virgen de la Arrixaca Murcia, Spain
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Abstract
Introduction

Although few cases of squamous cell carcinoma (SCC) with clear cells have been published, we believe that these cells are often present in SCC.

Material and methods

We studied 249 SCCs, analyzing a number of clinical and histological variables. Various immunohistochemical techniques (immunoperoxidase method) were used to determine whether adnexal differentiation was present.

Results

There were 96 SCCs with a proportion of clear cells of over 25%. Advanced or established SCCs and SCCs associated with Bowen disease contained a larger proportion of clear cells. We defined 2 histological patterns: a) clear cells around the keratin pearls of SCCs arising from pre-existing actinic keratosis and with indirect signs of human papilloma virus infection in hair follicles; and b) clear cells that simulate adnexal differentiation in lesions arising on pre-existing Bowen disease lesions. There were also 19 carcinomas with true adnexal differentiation.

Discussion

Clear cells are frequently observed in SCC, though large numbers of clear cells are present only in certain SCCs. The appearance of clear cells in SCCs is progressive and they are only present in more advanced SCC. The presence of clear cells is suggestive of adnexal differentiation; however, in the majority of cases, their presence is due to infiltration of normal adnexal structures by the cells of pagetoid Bowen disease. True adnexal differentiation exists only in a small percentage of cases (7.6% in our study). The histological pattern described as clear cells around keratin pearls practically rules out this differentiation.

Key words:
clear cells
squamous cell carcinoma
skin
dermatopathology
Resumen
Introducción

Se han publicado pocos casos de carcinoma espinocelular (CE) de células claras, aunque creemos que es frecuente observar células claras en los CE.

Material y métodos

Hemos estudiado 249 CE. Analizamos distintas variables clínicas e histológicas. Hemos usado diversas técnicas de inmunohistoquímica (método de inmunoperoxidasa) para valorar si existía diferenciación anexial.

Resultados

Observamos 96 CE con más de un 25% de células claras. Existe más cantidad de células claras en los CE desarrollados o «no incipientes» y en los derivados de enfermedad de Bowen (EB). Describimos dos patrones histológicos: a) células claras alrededor de las perlas córneas del CE, que se asocia a la existencia de queratosis actínica como lesión previa y a signos indirectos de virus del papiloma humano (VPH) en infundíbulos pilosos, y b) células claras que simulan diferenciación anexial, relacionado con EB como lesión previa. También hemos encontrado 19 carcinomas con verdadera diferenciación anexial.

Conclusiones

Es frecuente observar células claras en los CE, aunque solo algunos presentan una gran cantidad. El desarrollo de células claras en los CE sería progresivo y solo aparecería en los CE más desarrollados. Cuando se observan células claras en los CE, se tiende a pensar que existe diferenciación anexial, sin embargo, en la mayoría de casos se trataría solo de EB de células claras que infiltra estructuras anexiales normales. En un pequeño porcentaje de casos (7,6% en nuestro estudio) sí existe verdadera diferenciación anexial. Por otra parte, el patrón histológico descrito como células claras alrededor de perlas córneas prácticamente nos descartaría dicha diferenciación.

Palabras clave:
células claras
carcinoma espinocelular
piel
dermatopatología
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This study was awarded the 2007-2008 August C. Stiefel Research Prize.

Copyright © 2009. Academia Española de Dermatología y Venereología and Elsevier España, S.L.
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