Difference between revisions of "Pilomatricoma"

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#redirect [[Non-malignant_skin_disease#Pilomatricoma]]
{{ Infobox diagnosis
| Name      = {{PAGENAME}}
| Image      = Pilomatrixoma_-_high_mag.jpg
| Width      =
| Caption    = Pilomatricoma. [[H&E stain]].
| Micro      = "ghost" cells, foreign body-type giant cells
| Subtypes  =
| LMDDx      = [[squamous cell carcinoma]], pilomatrix carcinoma, [[basal cell carcinoma]], [[epidermal inclusion cyst]], [[heterotopic ossification]]
| Stains    =
| IHC        =
| EM        =
| Molecular  =
| IF        =
| Gross      = skin nodule, hard
| Grossing  =
| Site      = [[skin]]
| Assdx      =
| Syndromes  =
| Clinicalhx = common in children
| Signs      = hard nodule
| Symptoms  = +/-painful
| Prevalence = common
| Bloodwork  =
| Rads      =
| Endoscopy  =
| Prognosis  = benign
| Other      =
| ClinDDx    = surgical excision
}}
'''Pilomatricoma''' is a benign [[skin]] lesion that is common in childhood. It may be spelled '''pilomatrixoma'''.
 
It is also known as '''calcifying epithelioma of Malherbe'''.<ref>{{Ref Derm|387}}</ref>
==General==
*Benign skin tumour.
*Most common solid skin tumour of children.<ref name=emed1058965>URL: [http://emedicine.medscape.com/article/1058965-overview http://emedicine.medscape.com/article/1058965-overview]. Accessed on: 10 September 2011.</ref>
*CTNNB1 gene mutation important in pathogenesis.<ref name=Ref_PCPBoD8_597>{{Ref PCPBoD8|597}}</ref>
 
Clinical:
*Hard nodule - calcification.
*+/-Painful.
 
Treatment:
*Surgical excision.<ref name=emed1058965>URL: [http://emedicine.medscape.com/article/1058965-overview http://emedicine.medscape.com/article/1058965-overview]. Accessed on: 10 September 2011.</ref>
 
==Microscopic==
Features:<ref name=emed1058965dx>URL: [http://emedicine.medscape.com/article/1058965-diagnosis http://emedicine.medscape.com/article/1058965-diagnosis]. Accessed on: 10 September 2011.</ref>
*Nodular circumscribed lower dermis/subcutaneous adipose lesion; thus, usu. surrounded by connective tissue.
**Sharpy demarcated island of cells.
**Calcification in 75%.
*Cells:<ref>[http://www.bccancer.bc.ca/HPI/CE/cytotechnology/cytosleuthquiz/nongyne/ngcase02d.htm http://www.bccancer.bc.ca/HPI/CE/cytotechnology/cytosleuthquiz/nongyne/ngcase02d.htm]</ref>
**Basaloid epithelial cells - have prominent nucleoli.
**Anucleate squamous cells ("ghost cells").
**Giant cell foreign body type [[granulomas]] (form in reaction to keratin).
 
Notes:
*Keratin a prominent feature on cytology - lots of orange stuff.
*May (extensively) ossify.<ref name=pmid20439187>{{Cite journal  | last1 = Ioannidis | first1 = O. | last2 = Stavrakis | first2 = T. | last3 = Cheva | first3 = A. | last4 = Papadimitriou | first4 = N. | last5 = Kotronis | first5 = A. | last6 = Kakoutis | first6 = E. | last7 = Makrantonakis | first7 = N. | title = Pilomatricoma of the arm with extensive ossification. | journal = Adv Med Sci | volume = 55 | issue = 2 | pages = 340-2 | month =  | year = 2010 | doi = 10.2478/v10039-010-0010-y | PMID = 20439187 }}</ref>
 
DDx:
*[[Epidermal inclusion cyst]].
*Pilomatrix carcinoma - invasive border, cytologic atypia, necrosis.<ref>{{Ref Derm|389}}</ref>
*[[Squamous cell carcinoma]].
*[[Basal cell carcinoma]].
*[[Heterotopic ossification]].
 
===Images===
<gallery>
Image:Pilomatrixoma_-_high_mag.jpg | Pilomatrixoma - high mag. (WC/Nephron)
Image:Pilomatrixoma_-_intermed_mag.jpg | Pilomatrixoma - intermed. mag. (WC/Nephron)
</gallery>
www:
*[http://www.bccancer.bc.ca/HPI/CE/cytotechnology/cytosleuthquiz/nongyne/ngcase02.htm Pilomatrixoma - cytology (bccancer.bc.ca)].
*[http://www.dermrounds.com/photo/1980062:Photo:431 Pilomatrixoma - histology (dermrounds.com)].
 
==Sign out==
<pre>
Skin Lesion, Left Forearm, Excision:
- Pilomatricoma with ossification.
</pre>
 
===Block letters===
<pre>
SKIN LESION, RIGHT ARM, EXCISION:
- PILOMATRICOMA.
</pre>
 
===Micro===
The sections show anucleate squamous cells ("ghost cells") and multinucleated giant cells. No calcification is present. 
No significant nuclear atypia is present. No mitotic activity is apparent.
There is also mildly inflamed fibroadipose tissue and some benign squamous mucosa.
====Alternate====
The sections show anucleate squamous cells ("ghost cells") and multinucleated giant cells. Calcification is present. No significant nuclear atypia is present. No mitotic activity is apparent. The lesion extends to the inked surface. No skin is present.
 
==See also==
*[[Dermatopathology]].
*[[Non-malignant skin disease]].
 
==References==
{{Reflist|2}}
 
 
[[Category:Diagnosis]]
[[Category:Dermatopathology]]

Latest revision as of 17:26, 12 December 2023

Pilomatricoma
Diagnosis in short

Pilomatricoma. H&E stain.
LM "ghost" cells, foreign body-type giant cells
LM DDx squamous cell carcinoma, pilomatrix carcinoma, basal cell carcinoma, epidermal inclusion cyst, heterotopic ossification
Gross skin nodule, hard
Site skin
Clinical history common in children
Signs hard nodule
Symptoms +/-painful
Prevalence common
Prognosis benign
Clin. DDx surgical excision

Pilomatricoma is a benign skin lesion that is common in childhood. It may be spelled pilomatrixoma.

It is also known as calcifying epithelioma of Malherbe.[1]

General

  • Benign skin tumour.
  • Most common solid skin tumour of children.[2]
  • CTNNB1 gene mutation important in pathogenesis.[3]

Clinical:

  • Hard nodule - calcification.
  • +/-Painful.

Treatment:

  • Surgical excision.[2]

Microscopic

Features:[4]

  • Nodular circumscribed lower dermis/subcutaneous adipose lesion; thus, usu. surrounded by connective tissue.
    • Sharpy demarcated island of cells.
    • Calcification in 75%.
  • Cells:[5]
    • Basaloid epithelial cells - have prominent nucleoli.
    • Anucleate squamous cells ("ghost cells").
    • Giant cell foreign body type granulomas (form in reaction to keratin).

Notes:

  • Keratin a prominent feature on cytology - lots of orange stuff.
  • May (extensively) ossify.[6]

DDx:

Images

  • Pilomatrixoma - high mag. (WC/Nephron)

  • Pilomatrixoma - intermed. mag. (WC/Nephron)

www:

Sign out

Skin Lesion, Left Forearm, Excision:
- Pilomatricoma with ossification.

Block letters

SKIN LESION, RIGHT ARM, EXCISION:
- PILOMATRICOMA.

Micro

The sections show anucleate squamous cells ("ghost cells") and multinucleated giant cells. No calcification is present. No significant nuclear atypia is present. No mitotic activity is apparent. There is also mildly inflamed fibroadipose tissue and some benign squamous mucosa.

Alternate

The sections show anucleate squamous cells ("ghost cells") and multinucleated giant cells. Calcification is present. No significant nuclear atypia is present. No mitotic activity is apparent. The lesion extends to the inked surface. No skin is present.

See also

References

  1. ↑ Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 387. ISBN 978-0443066542.
  2. ↑ 2.0 2.1 URL: http://emedicine.medscape.com/article/1058965-overview. Accessed on: 10 September 2011.
  3. ↑ Mitchell, Richard; Kumar, Vinay; Fausto, Nelson; Abbas, Abul K.; Aster, Jon (2011). Pocket Companion to Robbins & Cotran Pathologic Basis of Disease (8th ed.). Elsevier Saunders. pp. 597. ISBN 978-1416054542.
  4. ↑ URL: http://emedicine.medscape.com/article/1058965-diagnosis. Accessed on: 10 September 2011.
  5. ↑ http://www.bccancer.bc.ca/HPI/CE/cytotechnology/cytosleuthquiz/nongyne/ngcase02d.htm
  6. ↑ Ioannidis, O.; Stavrakis, T.; Cheva, A.; Papadimitriou, N.; Kotronis, A.; Kakoutis, E.; Makrantonakis, N. (2010). "Pilomatricoma of the arm with extensive ossification.". Adv Med Sci 55 (2): 340-2. doi:10.2478/v10039-010-0010-y. PMID 20439187.
  7. ↑ Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 389. ISBN 978-0443066542.
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