Cytology of Eyelid Squamous cell carcinoma

Macroscopy: Plaque, nodular and/or ulcerative lesion. Microscopy: Scraping samples of squamous cell carcinoma are better observed with Papanicolaou-stained in which squamous cytoplasmic differentiation is more evident. The cytological pattern may vary according to cellular differentiation, which ranges from extremely well-differentiated to anaplastic. When almost all cells show indirect signs of paracheratosis, such as wide and extremely keratinizing cytoplasm with retention of small pyknotic nuclei, but the smear lacks cells from a possible lesion beneath, cytological diagnosis should be delayed. A variable number of granulocytes may also be present in the smears, depending on the presence of necrosis. Inflammatory infiltrate may also characterize non-tumuoral ulcerated lesions in which scraping may be requested, in this case the scraping should be effected at the edge of the lesion and not at the centre. It may also be useful to remember that benign ulcerated lesions are generally more painful when scraped than tumours, produce fewer cellular smears and obviously yield cells with a lesser degree of atypia. Immunophenotype Not applicable Molecular features Not applicable. Differential diagnosis Bowen disease, BC