儿童穿通型毛母质瘤29例临床病理特点分析

目的:分析儿童穿通型毛母质瘤的临床及病理特点,探讨其发生机制。方法:回顾2014—2020年就诊于北京儿童医院皮肤科的29例穿通型毛母质瘤患儿资料,分析其临床及组织病理学特点。结果:29例中男11例,女18例,男女比例为1∶1.64。发病年龄3个月至14岁10个月,中位发病年龄4.58岁。病程2个月至2年,平均8.72...     

Anetodermic pilomatricoma

A pilomatricoma, or Malherbe's calcifying epithelioma, is an uncommon tumor originating from hair matrix cells. It is clinically characterized by a solitary, firm nodule. As the skin overlying the pilomatricoma may change in color and texture, its clinical presentation can vary. We report an unusual case of pilomatricoma with associated anetoderma on the lower extremity of a 12-year-old girl. Histology revealed a thinned dermis replaced by myxomatous tissue between the surface and a deep-seated tumoral mass. This mass is formed of irregular islands of basaloid cells, shadow cells, calcified areas and discrete inflammatory and foreign-body reactions surrounding it. Anetodermic cutaneous changes may occur in pilomatricomas without histological evidence of triggering factors.     

Bullous Pilomatricoma: A Report of Clinical and Pathologic Findings and Review of Dermal Bullous Disorders

BACKGROUND: Pilomatricoma is a common benign adnexal tumor differentiating toward elements of the hair matrix and shaft. It typically presents as a solitary, deep, dermal nodule. We describe a case of a pilomatricoma with the unusual feature of a thick-walled dermal bulla overlying the tumor. OBJECTIVE: We describe a case of bullous pilomatricoma and discuss the potential etiology of the bullous feature of the lesion. METHODS: This article includes a case report and a literature review. CONCLUSIONS: Bullous pilomatricoma has rarely been described. A common pathological feature in this type of pilomatricoma is the presence of dilated lymphatics. Bullous morphea associated with dermal lymphatic dilation has also been described. In both bullous pilomatricoma and morphea, it is possible that individual pathological features of the lesion lead to obstruction and congestion of the dermal lymphatics thereby inducing enough dilation and edema to form a dermal bulla.     

Perforating pilomatricoma: transepithelial elimination or not

We present a 56-year-old woman with a perforating pilomatricoma in the left eyebrow region. Histologically, the tumor consisted mainly of basophilic cells and shadow cells, and the tumor components were being eliminated through an ulcer with damage to the epithelial structures. In past reports of perforating pilomatricoma, this elimination pattern has often been described as transepithelial elimination. In many patients with perforating pilomatricoma, elimination is accompanied by ulceration and epithelial damage. Mehregan recently stated that elimination accompanied by epidermal necrosis and superficial ulceration constituted one form of transepithelial elimination. Epidermal necrosis and ulceration generally constitute severe damage. However, when Mehregan first proposed the concept of transepithelial elimination, it was defined as a phenomenon with relatively little or no damage to the epithelial structures, differentiating it from other types of elimination. This original definition makes transepithelial elimination a unique and interesting phenomenon, and its most important feature is that there is relatively little or no damage to the epithelial structures. Therefore, the terms "epidermal necrosis" and "ulceration" should not be used in association with transepithelial elimination. Hence, in patients with perforating pilomatricoma, the elimination of tumor components from ulcers with damage to the epithelial structures, as seen in the present case, should not be described as transepithelial elimination.     

Confused subcutaneous nodules in children: Differential diagnosis of pilomatricoma in children

Background

Pilomatricoma is a common but easily misdiagnosed tumor in children.

Aims

To differentiate pilomatricoma from other common subcutaneous nodules in children.

Patients/Methods

Misdiagnosed subcutaneous nodules in four children were recorded.

Results

A red mass on a 7-year-old boy's head which had been misdiagnosed pyogenic granuloma was proved to be pilomatricoma. A red mass on an 8-month-old boy's face which had been misdiagnosed infantile hemangioma also turned to be pilomotricoma. A red mass on a 21-month-old girl's breast, which had been misdiagnosed pilomatricoma, was proved to be infantile myofibroma. A subcutaneous nodule under a 13-month-old girl's armpit, which had been misdiagnosed pilomatricoma, turned to be BCG-associated lymphadenitis.

Conclusions

When a child with a subcutaneous nodule attends, pilomatricoma, vascular tumors, fibrous tumors, and BCG-associated lymphadenitis should be considered.     

Malignant pilomatricoma

An 86-year-old man had a tumor in the right posterior cervical region. The lesion showed histopathologic features of pilomatricoma but differed from that lesion by the presence of cytologically atypical cells and focal squamoid differentiation. The term "malignant pilomatricoma" is suggested for this tumor.     

Basal Cell Carcinoma With Matrical Differentiation in a Transplant Patient: A Case Report and Review of the Literature

Background: Shadow cells are characteristic of pilomatricoma, a distinct neoplasm of hair matrix differentiation. Shadow cells within an otherwise classic basal cell carcinoma (BCC) has been referred to as "BCC with matrical differentiation". We present a case of BCC with matrical differentiation in a transplant patient. To our knowledge, none have been reported arising on the background of immunosuppression. Methods: A 58‐year‐old male cardiac transplant patient had a left hand nodule, which was excised and submitted for routine histologic review. Results: The lesion revealed multiple basaloid tumor masses. In some areas, there was peripheral palisading with stromal retraction artifact, typical of basal cell carcinoma, extending into the deep reticular dermis. The tumor also contained a population of shadow cells, similar to those in pilomatricoma, with basaloid cells in the periphery. Trichohyaline granules were identified in many of the tumor cells. These granules are a hallmark of follicular matrix differentiation. Mitoses were rare. There was no evidence of an infiltrating growth pattern. Conclusion: Basal cell carcinoma with matrical differentiation is a rare subtype of basal cell carcinoma featuring shadow cells, such as those typically seen in pilomatricoma. This tumor has not yet been reported in an immunosuppressed transplant patient.     

Proliferating pilomatricoma in a 9-year-old girl

Proliferating pilomatricoma is a rare, benign tumor of hair matrix origin that rarely occurs in children. We report the case of a 9-year-old girl with a rapidly growing, proliferating pilomatricoma located on the glabella. The lesion was embolized and surgically excised, with histopathological examination of the tissue confirming the diagnosis of proliferating pilomatricoma.     

A case of perforating pilomatricoma

Pilomatricoma is a rare skin neoplasm, most commonly seen in the head and neck region, and occurring in the first two decades of life. It is usually solitary and varies from 0.5 to 2 cm in diameter. Its etiology is unknown. Perforating pilomatricoma is a rare clinical variant that presents as a draining, crusted nodule or ulcer, and is reported to arise faster than the classic pilomatricoma. Herein, we report a case of 35-year-old female, who had a 4-month history of a growing mass on her leg. On physical examination, a 4-cm diameter, asymptomatic, erythematous, ulcerated mass was noted on the left anterio-lateral upper leg. The first histopathological analysis of a punch biopsy from the lesion was reported as basal cell carcinoma. Therefore, the lesion was totally excised. There were shadow cells, squamoid cells, and basaloid aggregations more prominently in the one area in the tumor. In addition, calcification, foreign body giant cells and inflammatory cells were present. Punch or excisional biopsies are preferred as a method of diagnosis for the majority of cutaneous neoplasms. If total excision is not the method of choice, multiple punch biopsies should be made from different areas in large skin tumors for correct diagnosis.     

Diagnosis of Pilomatricoma Using an Otoscope

Abstract: Pilomatricoma is a benign tumor that presents as a 3–30‐mm, firm, solitary, deep, dermal or subcutaneous tumor on the head, neck, or upper extremities. The clinical diagnosis is often made by the firm, sometimes rock‐hard texture of the skin. The diagnosis can be confirmed by a skin biopsy or excision of the lesion. We have recently noted that pilomatricomas appear as a black mass in the skin when the lesion is transilluminated by placing the light of a fiberoptic otoscope adjacent to the skin lesion. To our knowledge, this is the first report demonstrating preoperative diagnosis of pilomatricoma by transilluminating the lesion with an otoscope.     

Follicular cyst derived from hair matrix and outer root sheath

A new follicular cyst was reported. The lower part of the cyst wall was composed of both basophilic and shadow cells as seen in pilomatricoma, whereas the upper part of the wall consisted of clear cells. Our case apparently derives from hair matrix and outer root sheath.     

Malignant pilomatricoma in a dog

A malignant pilomatricoma is described in a dog. The primary tumor apparently developed in the metatarsal area where there were multiple intradermal skin nodules. Lymphatic invasion by tumor cells resulted in metastasis to the mammary glands, lymph nodes and lungs. The tumor is compared to the pilomatricoma in man where no metastasizing types have been identified.     

穿通性毛母质瘤1例

报告1例穿通性毛母质瘤。患者女,60岁。因背部结节4个月就诊。皮肤科检查示背部有一突出皮面的紫红色结节,直径0.9cm结节中心有破溃。予以手术切除。组织病理检查示穿通性毛母质瘤。     

Melanocytic matricoma: case confirmation of a recently described entity

BACKGROUND: In 1999, Carlson et al. reported two cases of a matrical neoplasm that recapitulates the bulb of the anagen hair follicle, which they designated as melanocytic matricoma. METHODS: Here we report a similar case in a 78-year-old white male, who presented with a 0.4 cm purple-black firm papule in the left preauricular area. RESULTS: Histologically, the tumor is composed of a dual cell population including admixed epithelial matrical and supramatrical cells with "shadow" cell formation and pigmented dendritic melanocytes. Immunohistochemical studies for cytokeratin highlighted the epithelial component and studies for S-100 protein, HMB-45, and vimentin confirmed the melanocytic component. The differential diagnosis considered includes pigmented variants of pilomatricoma, matrical carcinoma, basal cell carcinoma and malignant melanoma. CONCLUSIONS: The case reported herein is the first confirmation of melanocytic matricoma, a distinctive adnexal neoplasm with characteristic clinical and pathologic features, which differentiate it from pigmented pilomatricoma.     

Extruding pilomatricoma. Report of a case

A young girl presented with an inflammatory papule, located on the right cheek, from which granular calcific material extruded. Histopathologic examination revealed the lesion to be a pilomatricoma. This type of clinical presentation, although apparently not unique, has not previously been reported. Furthermore, histochemical staining revealed that calcification may be seen early in the life history of a pilomatrixoma.     

Pilomatrix carcinoma arising from pilomatricoma after 10‐year senescent period: Immunohistochemical analysis

Pilomatrix carcinoma is a rare malignant counterpart of pilomatricoma. To our knowledge, only approximately 90 cases have been published in English literature. Pilomatrix carcinoma is locally aggressive and occasionally shows rapid progression infiltrating to the muscle, bone and vessels. We report a case of pilomatrix carcinoma that developed in a 38‐year‐old man and started to grow after a long stable period, relapsed for a short time and infiltrated into the muscle underneath. While the initial skin biopsy showed histopathological findings consistent with pilomatricoma, the recurrent tumor contained marked cellular atypia and an aggressive growth pattern. Although it is still controversial whether pilomatrix carcinoma arises de novo or through malignant transformation of a pilomatricoma, the present case might be caused by the latter process considering the patient’s clinical course. β‐catenin is a downstream effecter in the canonical pathway of Wnt, acting as a signal for cell differentiation and proliferation. The characteristic nuclear staining pattern of β‐catenin in the basaloid tumor cells, which is usually observed in pilomatrix carcinoma, supported the diagnosis of pilomatrix carcinoma in the present case.     

水疱型毛母质瘤一例

患者,女,11岁.左上臂水疱样肿物1年.组织病理示真皮内见镜影细胞、过渡细胞及嗜碱性细胞构成界清团块,胶原纤维稀疏,周围可见淋巴细胞和多核巨细胞浸润.诊断:水疱型毛母质瘤.治疗:手术切除.伤口愈合良好.     

Pilomatricomal horn: a new superficial variant of pilomatricoma

We describe a pilomatricomal horn on the right arm of a 39-year-old man. Although initially the tumor was clinically thought to be a verruca vulgaris, the microscopic features were similar to those found in classic pilomatricoma, except for the epidermal location and the presence of a cutaneous horn. Light microscopy showed replacement of the epidermis by basaloid cells, with masses of cornified material containing shadow cells that formed a cutaneous horn. Whereas classic pilomatricoma is confined to the deep reticular dermis or subcutis, the present case represents a unique heretofore unreported epidermal variant of pilomatricoma that pathologists should be aware of to differentiate it from malignant epidermal tumors.     

Bone morphogenetic protein-mediated type II collagen expression in pilomatricoma and cutaneous mixed tumor

BACKGROUND: We have previously reported that type II collagen deposition in overlying dermo-epidermal junction (DEJ) of pilomatricoma is mediated by bone morphogenetic protein 2/4 (BMP 2/4) expressed by shadow cells (SCs) of pilomatricoma. OBJECTIVE: This time, we studied the expression of type II collagen and BMP in a large number of cases of pilomatricoma and extended our study to cutaneous mixed tumor (CMT). RESULTS: We found type II collagen deposition in the overlying DEJ (16 of 50 cases) and in the SCs (19/50) of pilomatricoma. The number of case of type II collagen deposition in DEJ (DEJ(+)) and in SCs (SC(+)) of pilomatricoma correlated to the chronological stage of pilomatricoma. We also found type II collagen deposition in overlying DEJ (two of 11) and in the stromal chondroid tissue (four of 11) of CMT. BMP 2 was expressed in most cases of pilomatricoma (37/50) and CMT (seven of 11). CONCLUSIONS: The expression of type II collagen in pilomatricoma is dependent upon the chronological stage of pilomatricoma. Type II collagen expression in the overlying DEJ and chondroid matrix in CMT may be induced by BMP via the same mechanism as in pilomatricoma.