Pilomatricoma

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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
Site skin

Signs hard nodule
Symptoms +/-painful
Prognosis benign

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 ossify.

DDx:

Images

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SKIN LESION, RIGHT ARM, EXCISION:
- PILOMATRICOMA.

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. Cite error: Invalid <ref> tag; name "emed1058965" defined multiple times with different content
  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. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 389. ISBN 978-0443066542.