Nodular BCC Features


  • Nodular basal cell nests have minimal connection to the epidermis with the main nest mass primarily localised within the papillary dermis or superficial reticular dermis


  • Nodular basal cell nests typically present as ovoid structures with a granular texture due to cell composition
  • Hyporeflectivity due to the basal cells possessing less intracellular keratin


  • All basal nests have a form of darker hyporeflective border, this characteristic is more prominent in nodular subtypes
  • Dark halo appearance due to a cleft region fully encompassing the nest and the presence of peripheral palisading


  • Prominence and thickness of cleft can vary between nests
  • More prone to have directed vasculature connecting with the nest (arborizing blood vessels)


  • Can occur as an aggregation of multiple nodules arranged horizontally across a region
  • Peripheral boundary in larger nodules is typically more visible on lower face of the nest as a more hyporeflective region


  • Larger nodules displace the normal mottled collagen texture of the dermis with a homogenous fine granularity corresponding to the basal cell population
  • Some nodules may take up the entire scan area but can be identified by the appearance of a gap between the nest and epidermis showing a fine, yet visible, cleft region


  • Larger nodules are prone to forming necrotic centres
  • The loss of the nest’s homogenous texture at the centre is due to necrotic cell debris and the presence of tissue fluid

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