FINE-NEEDLE ASPIRATION CYTOLOGY OF METASTATIC BASAL-CELL CARCINOMA OFTHE SKIN TO THE LUNG

Metastatic basal cell carcinomas of the skin are rare. We present the cytologic features of a metastatic basal cell carcinoma to the lung di agnosed by fine-needle aspiration biopsy. Cytologic examination reveal ed syncytial groups of relatively small cells with hyperchromatic, ova l to spindle-shaped nuclei having high nuclear to cytoplasmic ratios. Immunocytochemical studies performed on the cell block sections reveal ed the malignant cells to be positive for cytokeratin (AE1/3) and nega tive for neuroendocrine markers, [neuron specific enolase (NSE) and ch romogranin (Phe-5)]. We reviewed the literature related to metastatic basal cell carcinoma of the skin and discuss risk factors and mechanis ms of metastatic spread In addition, a discussion of the other entitie s that can enter into the differential diagnosis is presented along wi th the role of ancillary studies. To the best of our knowledge, we bel ieve this is the first case report of the fine-needle aspiration (FNA) cytology of a basal cell carcinoma metastatic to the lung.