水疱型毛母质瘤1例及文献回顾

正水疱型毛母质瘤(bullous pilomatricoma)又叫皮肤松弛型毛母质瘤(anetodermic pilomatricoma)或淋巴管扩张型毛母质瘤(lymphangiectatic pilomatricoma),是毛母质瘤的一种特殊类型,具有水疱外观,触之质软。现报告1例水疱型毛母质瘤,并汇总既往中外文献共33例病例进行分析讨论。1病历摘要患者男,24岁,汉族。因背部丘疹、结节3个月余于     

水疱型毛母质瘤3例分析

本文详述3例水疱型毛母质瘤临床、病理特点及治疗方法,分析了水疱型毛母质瘤临床及病理特点。3例患者手术切除后经过随访治疗效果满意。水疱型毛母质瘤有其独特的临床及病理特点,手术切除是最佳治疗手段。     

儿童穿通型毛母质瘤四例

毛母质瘤又称Malherbe钙化上皮瘤,首先由Malherbe和Chenantais于1880年报道[1]。临床上偶可见到穿通型毛母质瘤、水疱型毛母质瘤及巨大型毛母质瘤等罕见类型[2]。我科自2012—2014年共收治4例穿通型毛母质瘤患儿,现报告如下。临床资料病例1,女,4岁7个月。主因右侧颈部肿物2年、破溃1.5年,于2012年12月24日就诊。2年前无明     

水疱型毛母质瘤1例

报告水疱型毛母质瘤1例。患者男,26岁,右肘部屈侧皮肤肿物7年。皮肤科检查：右肘部屈侧可见一约3.0 cm×3.0 cm×1.0 cm大小类圆形松弛的淡红色水疱,隆起皮面,边界清楚,无破溃与渗液,触之有波动感,水疱基底部可扪及一约1.5 cm×1.0 cm×0.3 cm大小的质硬结节,活动度差,形状欠规则,触压痛不明显。皮损组织病理：表皮正常,肿瘤位于真皮内,肿瘤细胞团块周围可见扩张淋巴管,其中充满淋巴液,肿瘤团块由基底样细胞及影子细胞构成。诊断为水疱型毛母质瘤。予手术完整切除,创面愈合良好。目前随访未复发。     

毛母质瘤伴多样化的临床病理特征

目的总结毛母质瘤疾病的临床病理特征。方法收集诊治的5例毛母质瘤的资料并复习相关文献,分析疾病的临床表现和病理特征。结果毛母质瘤表现多样,可伴或不伴表皮改变,表现为经典型、伴发表皮囊肿型、穿通型、水疱型、恶性毛母质瘤。结论毛母质瘤临床病理表现多样,组织病理是其诊断金标准。     

10例毛母质瘤的皮肤镜特征分析

目的:对毛母质瘤的皮肤镜特征进行总结,为提高毛母质瘤的临床诊断率提供一些线索。方法:收集分析行病理学检查及皮肤镜检查的毛母质瘤患者临床资料。结果:共收集10例毛母质瘤患者,其中男5例,女5例,年龄3～22岁。7例(70%)毛母质瘤位于头面部,2例(20%)位于上肢,1例(10%)位于肩颈部。初步临床诊断包括毛母质瘤、皮肤肿物、瘢痕疙瘩、化脓性肉芽肿、表皮囊肿、传染性软疣、皮脂腺增生、Spitz痣,临床诊断符合率仅为20%。毛母质瘤最常见的皮肤镜特征包括黄白色无结构区(90%)、紫红色均质区域(80%)、不规则分枝状血管(60%)及白色条纹(60%)。结论:毛母质瘤初步诊断误诊率高,皮肤镜常见表现为黄白色无结构区、紫红色均质区域、不规则分枝状血管及白色条纹等。     

多发性囊性毛母质瘤1例

报告1例青年女性多发性囊性毛母质瘤患者。患者女,18岁,因左上肢、颈后肿物1年就诊。皮肤科检查:左上肢和颈后两处粉红色囊性肿物,水疱样外观,触之凹陷,囊肿内有质硬肿块,可移动,无触压痛。组织病理检查:皮下可见不规则的上皮细胞岛,周围有结缔组织包裹。细胞岛由嗜碱性细胞和影细胞组成。诊断为毛母质瘤。     

穿通性毛母质瘤

报告1例穿通性毛母质瘤.患儿女,10岁.左上臂外侧出现一红色丘疹,偶有疼痛,逐渐增至玉米粒大,中央破溃1年.皮肤科检查:左上臂后外侧见一玉米粒大的紫红色半球形结节,质硬,中央破溃呈脐窝状.经皮损组织病理检查诊断为穿通性毛母质瘤.     

多发性囊性毛母质瘤1例

报告1例青年女性多发性囊性毛母质瘤患者。患者女，18岁，因左上肢、颈后肿物1年就诊。皮肤科检查：左上肢和领后两处粉红色囊性肿物，水疱样外观，触之凹陷，囊肿内有质硬肿块，可移动．尢触压痛、组织病理检查：皮下可处不规则的上皮细胞岛，周围有结缔组织包裹。细胞岛由嗜碱性细胞和影细胞组成。诊断为毛母质瘤。     

巨大型水疱型毛母质瘤

报告1例巨大型水疱型毛母质瘤.患者男,24岁.因左上臂肿块7个月,表面出现水疱3个月余就诊.皮肤科检查:左上臂见一12.5cm×6c@m囊样肿块,囊壁松弛,表面呈暗红色,内含黄色血清样液体,触诊可及一质硬肿块,界清,无压痛.手术切除整个新生物后行组织病理检查:真皮中下部由嗜碱性细胞、过渡细胞和影细胞构成边界清楚的肿瘤团块,肿瘤团块上部真皮浅层可见淋巴水肿、增生扩张的淋巴管,其中充满淡嗜伊红淋巴液,胶原纤维稀疏.诊断:巨大型水疱型毛母质瘤.     

Pilomatricoma with a bullous appearance

BACKGROUND: Pilomatricoma is a benign, cutaneous neoplasm with differentiation toward hair matrix. The tumor is usually a deep-seated, solitary, firm nodule with overlying normal epidermis. Pilomatricoma with a bullous appearance is very rare. METHODS: A 16-year-old Chinese girl with a soft, purplish, translucent bulla on the left shoulder for 6 months and a nodule underlying the bulla is described. RESULTS: The histopathologic findings were consistent with pilomatricoma. There was extraordinary dilation of lymphatic vessels in the overlying dermis, which explains the clinical bullous appearance. The surrounding dermis had an edematous appearance. A Verhoeff-van Gieson stain disclosed the marked reduction of the elastic fibers, and an alcian blue stain was negative. CONCLUSIONS: The patient is diagnosed as bullous variant of pilomatricoma.     

Giant pilomatricoma

A 52-year-old man was examined for an ulcerated, rapidly growing reddish nodule. It was 5.5 cm high with an 11 x 6-cm base and located on the left clavicle. The lesion had been present for approximately 7 years, and the patient complained occasional burning and pain. Clinical differential diagnoses included cutaneous lymphoma, sarcoma, squamous cell carcinoma, and cutaneous metastasis. Histopathologic examination revealed a well-circumscribed tumor involving the whole dermis and the subcutis and composed of partially confluent aggregates of matrical cells admixed with eosinophilic cornified material containing shadow cells. In addition, multinucleated giant cells, areas of calcification and metaplastic ossification, edema, and hemorrhage were also observed. On the basis of histopathologic features, the diagnosis of pilomatricoma was made. Our report highlights an unusual clinical appearance of pilomatricoma that made us consider a variety of primary or secondary cutaneous neoplasms in its differential diagnosis.     

Perforating pilomatricoma

A case of "perforating pilomatricoma" is reported. A cutaneous horn-like tumor, the size of a grain of rice, developed on the left upper arm of a 51-year-old man. Histological examination revealed typical microscopic features of pilomatricoma. In addition, however, an interesting phenomenon was observed: a small portion of the mass had extruded from the upper dermis to the skin surface through the perforated epidermal channel. It might have been possible in this case for all of the tumor mass to be extruded by transepithelial elimination.     

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。     

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.     

息肉性毛母质瘤1例

患者男,20岁。左侧背部出现息肉状损害半年余。皮肤科情况:左侧背部可见一约鸡蛋大半透明的大疱状损害,其中央可触及一约蚕豆大形状不规则结节,质坚,无明显压痛。手术切除物组织病理示:真皮内可见大量境界清楚的由影细胞、嗜碱性细胞和过渡细胞组成的细胞团块。诊断:息肉性毛母质瘤。     

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.     

Anetodermic pilomatricoma: molecular characteristics and trauma in the development of its bullous appearance

Pilomatricoma is a common benign neoplasm of the skin characterized by a solid cutaneous nodule of hair matrix origin. The anetodermal or lymphangiectatic variant of pilomatricoma is rare, and its bullous appearance is often associated with attenuated collagen and elastic fibrils and dilated lymphatic vessels in the overlying dermis. However, the tumors of anetodermic pilomatricoma have never been characterized at the molecular level, and the exact mechanism for their development is unknown. In this study, we evaluated histological and molecular features of a bullous pilomatricoma along with 5 control tumors and determined that tumors of both anetodermic and control pilomatricoma comprise similar molecular features, such as nuclear lymphoid enhancer binding factor 1 (LEF1) localization and the expression of keratins. In addition, we associated the development of the anetodermic pilomatricoma with mechanical trauma, scar tissue formation, and increased numbers of blood and lymphatic vessels. This study suggests that the development of the anetodermic form of pilomatricoma is unlikely to be associated with the intrinsic properties of the tumor but with the mechanical trauma that disrupts the dermal integrity and vascular microenvironment.     

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.