Tuesday, August 14, 2012

Morpheaform Basal Cell Carcinoma

Morpheaform basal cell carcinomas are noted for their hard, scar-like appearance (hence the name) and their notable pathology, which is remarkable for the spikes and strands of BCC, some of which are 1 or 2 cells thick.  They are, as we previously discussed, representative of "worm holes" into the surrounding tissue, and act very differently from a nodular BCC.

So, as I am operating, I often wonder: Is a morpheaform BCC morpheaform because of the way the tmor acts (the genes that are expressed) or is it a "host factor" issue?  My feeling is this: Although the BCC is fundamentally different than a nodular BCC, you gotta figure that they are genetically identical to a nodualr BCC (more on that in a moment) but you also have to figure that it is not just host factors that makes it into a clonal spaghetti that cuts through the reticular dermis and into surrounding tissue.  And, why does it like nerves?

I think it is expression of histones, which dictate the way genes are expressed, which gives the morpheaform BCC its character.  Think of genes as a series of possibilities, and histone expression as a series of options within the genes.  These histones that are expressed lead to the spiky, worm like expression, andalso (see above) the upregulation of fibroblasts to squirt out collagen, as opposed to squirting out mucin, as in a nodular BCC.  

Speaking of nodular BCCs, the best way, by far, to create a morpheaform BCC is to freeze a nodular BCC, which will often create a badass tumor which will grow unimpeded for months or even years before detection.  So, don't do it.

No comments:

Post a Comment