Clinicopathologic features of skin cancer in organ transplant recipients: A retrospective case-control series Catherine A. Harwood, MA, PhD, MRCP, Charlotte.

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Clinicopathologic features of skin cancer in organ transplant recipients: A retrospective case-control series Catherine A. Harwood, MA, PhD, MRCP, Charlotte M. Proby, MA, FRCP, Jane M. McGregor, MA, MD, FRCP, Michael T. Sheaff, FRCP, FRCPath, Irene M. Leigh, FRCP, DSc, Rino Cerio, FRCP, FRCPath Journal of the American Academy of Dermatology Volume 54, Issue 2, Pages 290-300 (February 2006) DOI: 10.1016/j.jaad.2005.10.049 Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 1 Spindle cell SCCs in transplant recipients. Low-power (A) and high-power (B) views of a transplant SCC showing diffuse spindle cell morphology. Such lesions often showed little evidence of squamous differentiation; however, in all cases, malignant cells were seen to be in continuity with the overlying epidermis, although multiple sectioning often was necessary to demonstrate this continuity. C, A pankeratin marker (MN116) was positive, although it failed to label many tumor cells; vimentin, desmin, S100 and CD34 were negative. D, One transplant spindle cell SCC spread from the right cheek to submandibular lymph nodes and subsequently metastasized to the iliac crest as indicated by arrows on this isotopic bone scan. (A and B, Hematoxylin-eosin stain; original magnifications: A, ×100; B and C, ×200.) Journal of the American Academy of Dermatology 2006 54, 290-300DOI: (10.1016/j.jaad.2005.10.049) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 2 Histologic features suggestive of HPV infection. Koilocytes in epidermis overlying a transplant SCC (A); parakeratosis, hyperkeratosis, hypergranulosis and koilocytosis in the epidermis associated with a microinvasive SCC in a transplant recipient (B); parakeratosis, hyperkeratosis, hypergranulosis in epidermis overlying (C) and contiguous (D) with transplant BCCs. (Hematoxylin-eosin stain; original magnifications: A, ×200; B and C, ×100; D, ×40.) Journal of the American Academy of Dermatology 2006 54, 290-300DOI: (10.1016/j.jaad.2005.10.049) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions

Fig 3 Features of transplant BCCs. Superficial BCCs and BCCs on extra-cranial sites were more common in transplant recipients. A, Two superficial BCCs denoted by black arrows are shown here on the upper chest of an RTR. B, A closer view of a similar superficial RTR-BCC. C, Low-power photomicrograph of a superficial RTR-BCC. D, Squamous differentiation with mild to moderate (but not severe) atypia also was more common in RTR-BCCs (C and D, Hematoxylin-eosin stain; original magnification: ×40.) Journal of the American Academy of Dermatology 2006 54, 290-300DOI: (10.1016/j.jaad.2005.10.049) Copyright © 2006 American Academy of Dermatology, Inc. Terms and Conditions