case_images: PMC9249521_01
case_images: Clinical manifestation and histopathology. (a) A polypoid nodule was seen on the nose tip. (b) The lateral view shows a stalk on the nose. (c) Dermoscopy shows arborizing vessels and pigmented ovoid nests. (d) A low-power view showed basophilic nests in the dermis (hematoxylin and eosin staining, x20). (e) A high-power view of the upper square showed basaloid cells with palisading (hematoxylin and eosin staining, x200). (f) A high-power view of the lower square showed cystic spaces (hematoxylin and eosin staining, x200). (g) Immunostaining with Ber-EP4 is more strongly positive in shallow lesions.
case_images: CRIDM2022-4087202.001.jpg
case_images: PMC9249521_01_CRIDM2022-4087202.001.jpg
case_images: fig1
case_images: An elastic, hard, 40 x 25 x 15-mm, pedunculated red-black nodule with a smooth surface was found on the nose (Figures 1(a) and 1(b)). However, a dermoscopy examination clearly showed arborizing vessels and black dots on its lower surface (Figure 1(c)), and a biopsy specimen revealed the nodular and cystic structure of basaloid cells, which was consistent with BCC. Histopathologically, there were two parts to this lesion, and a nodular and adenoid structure of basaloid cells was observed in the dermis (Figure 1(d)). A cleft between the tumor and stroma was observed (Figure 1(e)). There were some areas of adenoid differentiation and pseudocyst formation due to tumor necrosis (Figure 1(f)). The staining was more strongly positive in shallow lesions than in deep lesions (Figure 1(g)). ki67-positive cells were not clearly different between shallow and deep lesions, and EMA was negative (data not shown).