Original ArticleMerkel Cell-Poor Trichoblastoma With Basal Cell Carcinoma-Like FociMisago, Noriyuki MD; Satoh, Toshimi MD; Miura, Yoshihiro MD; Nagase, Kohtarou MD; Narisawa, Yutaka MDAuthor Information From the Division of Dermatology, Department of Internal Medicine (N.M., Y.M., K.N., S.K., Y.N.); and Department of Pathology (T.S.), Faculty of Medicine, Saga University, Saga, Japan. Reprints: Noriyuki Misago, MD, Division of Dermatology, Department of Internal Medicine, Faculty of Medicine, Saga University, Nabeshima 5-1-1, Saga 849-8501, Japan (e-mail: [email protected]). The American Journal of Dermatopathology: June 2007 - Volume 29 - Issue 3 - p 249-255 doi: 10.1097/DAD.0b013e31803335a2 Buy Metrics Abstract We reexamined 11 cases of trichoblastoma, and two cases of trichoblastoma with basal cell carcinoma (BCC)-like foci were found. In these two trichoblastomas with BCC-like foci, the BCC-like foci were often localized in peripheral or deep areas of lesions extending out of the fibrocytic stroma. Immunohistochemistry was performed in five conventional trichoblastomas and in two trichoblastomas with BCC-like foci, using antibodies against CK20 and CK15. No CK20-positive Merkel cells and no expression of CK15 were seen in any neoplastic aggregations of the two trichoblastomas with BCC-like foci. In contrast, increased numbers of Merkel cells and positive staining for CK15 were observed in all five trichoblastomas without BCC-like foci. The five trichoblastomas without BCC-like foci included two trichoblastomas with a popped out or shelled out appearance, which characteristically had a thick fibrous capsule surrounding the fibrotic stroma, demonstrating numerous Merkel cells in the aggregations. Some trichoblastomas may undergo mutations, resulting in the development of foci of BCC and in the loss of the expression of CK15 as well as the disappearance of Merkel cells. © 2007 Lippincott Williams & Wilkins, Inc.