Step 1: Decode the buzzword. A keratin or epithelial pearl is a round nest of cells laying down keratin in the center. Only a tumor arising from keratin-making squamous epithelium can do this, which points straight to squamous cell carcinoma.
Step 2: Confirm the microscopy. Well-differentiated squamous cell carcinoma shows nests of malignant squamous cells with central keratin pearls, intercellular bridges and cells with dense pink (eosinophilic) cytoplasm. The better differentiated the tumor, the more pearls you see.
Step 3: Compare the alternatives. Basal cell carcinoma forms islands of basaloid cells with palisaded edges and no true pearls. Melanoma is made of atypical pigment-bearing melanocytes, and lymphoma is a sheet of malignant lymphocytes. None keratinize.
Step 4: Settle the answer. Keratinization plus pearl formation is the signature of squamous cell carcinoma.
\[\boxed{\text{Squamous cell carcinoma}}\]