毛发上皮瘤与角化型基底细胞癌细胞形态及DNA含量定量分析

目的利用体视学技术对毛发上皮瘤及角化型基底细胞癌组织病理相似部分基底样细胞瘤块进行细胞形态及细胞核ＤＮＡ含量分析。方法每组各选５例进行细胞及细胞核形态及大小的测定,各选３０例进行细胞核ＤＮＡ含量定量分析。结果细胞形态及大小两组无差异（Ｐ＞０．０５）,细胞核形态及大小的各参量值两组有显著性差异（Ｐ＜０．０５）。毛发上皮瘤组３０例均为二倍体,角化型基底细胞癌组有异倍体１６例。结论两组肿瘤细胞的形态及大小相似,但角化型基底细胞癌的细胞核相对较大,且不规整,显示了恶性肿瘤的形态学特征。角化型基底细胞癌呈恶性生物学行为,而毛发上皮瘤则呈良性。     

角化型基底细胞癌与毛发上皮瘤细胞形态定量分析

角化型基底细胞癌为皮肤的一种恶性肿瘤，毛发上皮瘤为良性肿瘤，两者在光镜下的组织病理具有形态相似的基底样细胞团索，有时易于混淆，给病理诊断带来困难。本研究采用大型自动化多功能图像分析仪（ＩＡＩ），以角化型基底细胞癌及毛发上皮瘤的石蜡组织切片进行细胞形态学的计量分析，利用形态计量的某些参数，将这两种组织病理易于混淆的良、恶性肿瘤进行比较和鉴别，以寻求一种较为客观的病理诊断方法。一、资料和方法标本收集：选择我科历年来经临床及组织病理确诊的角化型基底细胞癌及毛发上皮瘤各５例患者的蜡块，将各蜡块制成４ｕｍ…     

人类原始抗原（CD34）在毛发上皮瘤和基底细胞癌中的表达

毛发上皮瘤是一种向毛囊分化的良性肿瘤，常与基底细胞癌混淆。应用人类原始抗原（ＣＤ３４）检测７例毛发上皮瘤和１２例基底细胞瘤中表达，结果：在正常皮肤血 皮细胞、血管周围和真皮内梭形细胞、毛囊、小汗腺周围梭形细胞阳性。毛发上皮瘤瘤团周围梭形细胞阳性，而基底细胞癌外周间质阴性，说明ＣＤ３４染色有助于临别这两种肿瘤。     

毛发上皮瘤12例临床病理学观察

目的：探讨毛叟皮瘤与皮肤附属器结构的关系。方法：观察与分析12例毛发上皮瘤的临床表现及组织形态学结构。结果：多发性毛发上皮瘤10例（83．3％），20岁以下发病9例（75％），组织病理学改变主要是基底细胞样细胞增生，向毛囊及皮腺脂导管分化。结论：毛发上皮瘤是一种向毛囊分化为主的皮肤附属器错构瘤。     

埃兹蛋白在皮肤鳞状细胞癌、基底细胞上皮瘤、脂溢性角化病中的表达及临床意义

目的 探讨埃兹蛋白（ezrin）在脂溢性角化病、基底细胞上皮瘤、皮肤鳞状细胞癌中的表达及其与临床病理参数之间的相关性。方法 采用免疫组化法（SP法）检测36例皮肤鳞状细胞癌、27例基底细胞上皮瘤和20例脂溢性角化病、10例正常人皮肤中埃兹蛋白表达水平。结果 埃兹蛋白在正常人皮肤、脂溢性角化病、基底细胞上皮瘤、皮肤鳞状细胞癌中的阳性率分别为20.0%,25.0%,66.7％和91.3%,除脂溢性角化病组外,各肿瘤组与正常人对照组比较,阳性率差异均有统计学意义（H = 40.061,P < 0.01）。埃兹蛋白表达水平与皮肤肿瘤良恶性、与皮肤鳞状细胞癌的病理分级及肿瘤有无淋巴结转移均呈正相关（r分别为0.87,0.80,0.89）。COX回归显示,埃兹蛋白表达水平是皮肤鳞状细胞癌预后的独立影响因素之一。结论 脂溢性角化病、基底细胞上皮瘤、皮肤鳞状细胞癌组织中埃兹蛋白阳性表达水平与皮肤肿瘤的良恶性、皮肤鳞状细胞癌病理分级及有无淋巴结转移有关。     

Ber EP4与EMA染色在皮肤基底细胞上皮瘤和鳞状细胞癌诊断中的意义

目的 观察BerEP4和EMA染色在皮肤基底细胞上皮瘤和鳞状细胞癌诊断中的意义.方法 用免疫组化SP法检测BerEP4和EMA在皮肤基底细胞上皮瘤、鳞状细胞癌、光线性角化病、Bowen病、脂溢性角化病、寻常疣和基底鳞状细胞癌皮损肿瘤成分及周围组织、皮肤附属腺体中的表达.结果 所有基底细胞上皮瘤和基底鳞状细胞癌肿瘤细胞呈BerEP4阳性,而鳞状细胞癌、光线性角化病、Bowen病、脂溢性角化病和寻常疣呈BerEP4阴性;多数鳞状细胞癌、Bowen病和部分光线性角化病肿瘤细胞及病变区域呈EMA阳性,而基底细胞上皮瘤、基底鳞状细胞癌、脂溢性角化病和寻常疣呈EMA阴性.结论 联合使用BerEP4和EMA能很好地协助诊断皮肤基底细胞上皮瘤、基底鳞状细胞癌、癌前病变及一些良性增生性皮肤病.     

毛发上皮瘤23例临床病理分析

毛发上皮瘤（trichoepithelioma),又名囊性腺样上皮瘤（epithelioma adenoides cystieum),是一种皮肤附属器肿瘤,起源于多分化潜能的基底细胞,并有向毛发分化的趋势。现将笔者1986-2004年4月诊治的23例毛发上皮瘤报告如下。     

脂溢性角化病并发基底细胞上皮瘤

报告1例脂溢性角化病并发基底细胞上皮瘤.患者女,60岁.鼻右侧出现新生物2个月,无痛痒.皮损组织病理检查示表皮角化过度,棘层肥厚,乳头瘤样增生,伴角囊肿形成,增生表皮由鳞状细胞和基底样细胞组成,其基底部与两侧正常表皮位于同一平面上;真皮浅层有基底样细胞形成的肿瘤团块,周边细胞呈栅栏状排列.依据临床和组织病理学改变,确诊为脂溢性角化病并发基底细胞上皮瘤.     

易误诊性单发结节皮肤镜及病理特征分析

目的 通过分析几组误诊单发结节的皮肤镜图像及病理特征,从而获取相关鉴别要点,提高诊断的准确性.方法 收集近2年皮肤镜误诊的单发结节共18例,重点选取频繁出现的疾病,观察和描述其皮肤镜下表现特征及病理特征,总结鉴别要点.结果 误诊疾病间皮肤镜下表现出相似的特征;与结节型基底细胞癌相比,毛发上皮瘤和角化棘皮瘤均有相对较细的...     

皮肤肿瘤

993694 毛发上皮瘤与角化型基底细胞癌细胞形态及DNA含量定量分析/邹勇莉（昆明医学院一附院皮肤科）…//中国皮肤性病学杂志。-1999,13（3）。-131 采用英国Cambridge公司的大型自动化多功能（Quantiment-900）图像分析仪,对HE染色的组织片进行细胞面积、周长、直径、圆度、体积的二者对比,每     

Follicular stem cell marker PHLDA1 (TDAG51) is superior to cytokeratin-20 in differentiating between trichoepithelioma and basal cell carcinoma in small biopsy specimens

Background: Biopsies submitted to dermatopathologists are becoming increasingly smaller in size and thus the available diagnostic material is reduced. The distinction between trichoepithelioma and basal cell carcinoma remains challenging, particularly if tissue is limited. Merkel cells, which can be highlighted by means of cytokeratin‐20 (CK20) immunostaining, are used as a surrogate marker for the diagnosis of trichoepithelioma, as Merkel cells commonly colonize trichoepithelioma but are generally lacking in basal cell carcinomas. In the current study, we examined the expression of a recently characterized follicular stem cell marker, PHLDA1 (pleckstrin homology‐like domain, family A, member 1), also known as TDAG51 (T‐cell death‐associated gene 51). Methods: Using standard immunohistochemical techniques, we examined 19 trichoepitheliomas and 11 basal cell carcinomas for the expression of PHLDA1 and compared it with CK20 expression. Results: All 19 trichoepitheliomas were immunoreactive for PHLDA1 and all 11 basal cell carcinomas lacked PHLDA1 expression. Two of eleven basal cell carcinomas harbored CK20‐positive Merkel cells. Three trichoepitheliomas lacked secondary CK20‐positive cells. Conclusions: Our results suggest that PHLDA1 represents a practical and easily used tool that can be applied to the differentiation of trichoepithelioma and basal cell carcinoma in small biopsy specimens. Rather than searching for CK20‐positive Merkel cells, assessing PHLDA1 expression allows the differential diagnosis between trichoepithelioma and basal cell carcinoma to be solved at scanning magnification. Sellheyer K, Nelson P. Follicular stem cell marker PHLDA1 (TDAG51) is superior to cytokeratin‐20 in differentiating between trichoepithelioma and basal cell carcinoma in small biopsy specimens.     

Basaloid follicular hamartoma with eruptive milia and hypohidrosis: is there a pathogenic relationship ?

We report a sporadic case of eruptive milia with histopathological features of basaloid follicular hamartoma which developed in an 8 year-old Japanese girl. Multiple milia and comedo-like eruptions were present at birth and gradually increased in number and spread over the extremities. Histopathologically, keratotic cysts with trichilemmal keratinization and features of basaloid follicular hamartoma were observed without any histological findings of basal cell epithelioma or trichoepithelioma. Reduced sweating was observed after iontophoretically applied acetylcholine on the forearm. Nevus of Ota and thyroid goiter were complications.     

肿瘤生长抑制基因ING1在基底细胞上皮瘤中的表达及突变分析

目的 研究肿瘤生长抑制基因ING1在基底细胞上皮瘤中是否存在过度表达及基因突变。方法 搜集了54份基底细胞上皮瘤标本，运用免疫组织化学染色，DNA单链构象多态性分析(SSCP)及DNA序列测定的方法研究ING1基因在基底细胞上皮瘤中的表达及突变情况。结果 免疫组化显示ING1基因在25％(6／24)基底细胞上皮瘤标本中过度表达。SSCP及DNA序列测定结果显示54例基底细胞上皮瘤标本中仅1例标本(1．8％)发生实质突变。突变发生在ING1基因编码区exon2，因而可能影响所有ING1异构体结构，并影响PHD锌指基序的功能。结论 ING1基因在基底细胞上皮瘤中无明显过度表达及突变。     

Histologic variation in the width of trichoepitheliomas

Our histopathological study deals with the evaluation of 232 solitary or multiple trichoepitheliomas, which have been examined by means of hematoxylin-eosin staining. The characteristic features of these benign adnexal tumors have been described with special emphasis on changes of the surrounding stroma. We found a great variation with regard to the size and number of cysts, the maturity of the epithelium and surrounding stroma, as well as the amount of affected stroma. In some cases, a clear separation between trichoepithelioma and keratinizing basal cell epithelioma was not possible.     

Desmoplastic trichoepithelioma. Clinical aspects, histology and differential diagnosis

Twelve desmoplastic trichoepitheliomas (DT) including one recurrent tumor from 9 patients are described by their clinical and histopathological features with special reference to the differential diagnostic aspects. DT typically appear as dimple lesions with raised edges in the faces of young females and histologically is composed of epithelial sheets and keratinized or calcified cysts in a desmoplastic stroma. A case showing cellular pleomorphism and followed by a relapse may represent an aggressive variant of DT. DT must be distinguished from syringoma, trichoepithelioma and especially basal cell carcinoma (BCC).     

Ultrastructure of Trichoepithelioma Papulosum Multiplex

The following features of trichoepithelioma papulosum multiplex (TPM) were revealed by electron microscopy: 1. Proliferation of basaloid cells similar to that in basal cell epithelioma (BCE). 2. Abortive hair shafts and hair papillae. 3. Keratinous cysts surrounded by flat keratinocytes, the cytoplasm of which had small-sized keratohyalin and Odland's bodies. 4. Glycogen deposition near the nuclei, vacuoles filled with amorphous materials and lipid droplets in the cytoplasm of tumor cells. 5. Extracellular compartments, in which fibrous materials, cell fragments, and mucinous substance were found. 6. Melanocytes containing melanosomes in stage 11, Langerhans cells involving Birbeck's granules, Merkel cells and other dendritic cells.     

p75 Neurotrophin receptor differentiates between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma: insights into the histogenesis of adnexal tumours based on embryology and hair follicle biology

Background Tumour development is frequently described in the basic pathology literature as a recapitulation of embryogenesis. However, a link between the embryology of the skin and the histogenesis of adnexal tumours has been largely overlooked. The low‐affinity p75 neurotrophin receptor (p75NTR) has a profound role in hair follicle biology. We therefore speculated that it is involved in the histogenesis of follicular adnexal tumours. One of the most challenging diagnoses in dermatopathology is differentiating morphoeic basal cell carcinoma from desmoplastic trichoepithelioma. Objectives To describe the expression pattern of p75NTR during cutaneous embryogenesis, in the adult hair follicle and in morphoeic basal cell carcinoma and desmoplastic trichoepithelioma. Methods Evaluation of the staining pattern for p75NTR was performed using standard immunohistochemical techniques. For comparison, we examined staining for cytokeratin 20 which highlights Merkel cells. Results All 17 desmoplastic trichoepitheliomas were immunoreactive with > 80% of the cells stained, whereas 12 of the 14 (86%) morphoeic basal cell carcinomas were p75NTR negative. In the two positive cases of morphoeic basal cell carcinoma < 30% of cells were labelled. In the late bulbous hair peg stage and in the postnatal anagen hair follicle p75NTR highlights the outer root sheath. Conclusions Our results support the classification of desmoplastic trichoepithelioma as a follicular hamartoma mimicking the outer root sheath. In contrast, the lack of p75NTR expression in morphoeic basal cell carcinoma favours a concept of this tumour as a more primitive follicular lesion with the characteristics of a carcinoma and not a hamartoma. We suggest including p75NTR as a tool in the differential diagnosis between morphoeic basal cell carcinoma and desmoplastic trichoepithelioma.     

Expression of trichohyalin in dermatological disorders: a comparative study with involucrin and filaggrin by immunohistochemical staining

To investigate the function of trichohyalin during terminal differentiation of the skin, immunohistochemical studies were performed on trichohyalin and its related proteins, filaggrin and involucrin, the components of the cornified cell envelope. In skin disorders unrelated to tumours, weak trichohyalin expression was found in a few granular cells or in the horny layer of psoriasis, ichthyosis, keratosis pilaris, porokeratosis, chronic dermatitis and callus. Similar trichohyalin expression was found in epidermal tumours, such as seborrheic keratosis, actinic keratosis, Bowen's disease and well-differentiated squamous cell carcinoma. In follicular tumours, trichohyalin expression was positive in trichoepithelioma, keratotic basal cell epithelioma, proliferating trichilemmal tumour, trichilemmoma, pilomatricoma and keratoacanthoma. From comparative studies with filaggrin and involucrin, trichohyalin expression was co-localized with them in molluscum contagiosum, keratoacanthoma and pilomatricoma. From this study, trichohyalin is revealed to have close functional relationship with other markers of terminal differentiation as a precursor of the cornified cell envelope of the skin.