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Pathology

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

Keratoacanthoma is characterized by:

  • keratin filled crypt
  • surrounding rapidly-dividing squamous cells
  • cellular changes:
    • atypial mitoses
    • loss of polarity

Lesions may exhibit pseudocarcinomatous features with nests of epithelial cells breaking away from the main body of the tumour. These may be difficult to differentiate from squamous cell carcinoma. Features suggesting keratoacanthoma include:

  • well-differentiated squamous cells:
    • little anaplasia or pleomorphism
    • excessive keratin productioin
  • a well-delineated border to the front of pseudocarcinomatous extensions
  • stromal fibrosis in the latter stages

Nevertheless, examination of a small area of biopsy may lead a histopathologist to an incorrect diagnosis of malignancy; it is prudent to relay the clinical suspicion of a keratocanthoma.

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