Trichoblastoma

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Trichoblastoma, also known as trichoepithelioma, is an uncommon skin tumour.

Trichoblastoma
Diagnosis in short

Trichoepithelioma. H&E stain.

LM typically well-circumscribed cell nest in the superficial dermis, surrounding by a fibrous stroma, basaloid cells - usu. with peripheral palisading +/-surround keratin-filled cysts, fibroblasts-like cell aggregate, similar to a follicular papillae (papillary-mesenchymal body)
Subtypes desmoplastic
LM DDx basal cell carcinoma, dermal cylindroma, trichofolliculoma, sebaceous carcinoma, microcystic adnexal carcinoma
Site skin

Prevalence uncommon
Prognosis benign

Trichoepithelioma is considered a superficial version of trichoblastoma; the World Health Organization lumps the two entities together.[1]

General

  • Benign.
  • May be familial:
    • Multiple familial trichoepithelioma.[2]
    • Brooke-Spiegler syndrome.

Microscopic

Features:[3]

  • Well-circumscribed cell nest in the superficial dermis.
  • Surrounding by a fibrous stroma.
  • Basaloid cells with peripheral palisading.
  • +/-Surround keratin-filled cysts.
  • Fibroblasts-like cell aggregate, similar to a follicular papillae (papillary-mesenchymal body).

Notes:

Variants:

  • Desmoplastic trichoblastoma.

DDx:

Images

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SKIN LESION, NOSE, BIOPSY:
- TRICHOBLASTOMA, COMPLETELY EXCISED.

Micro

The sections show well-circumscribed dermal nests of basaloid cells with peripheral palisading surrounded by a dense fibrous stroma. There is no artefactual clefting between the stroma and basaloid cell nests. Mitotic activity is minimal. Smaller hyperchromatic spindled-to-epithelioid cells in clusters (papillary-mesenchymal bodies) are found within the basaloid cells nests.

The epidermis show maturation to the surface and does not have basal atypia.

The lesion is completely excised in the plane of section.

See also

References

  1. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 383. ISBN 978-0443066542.
  2. Salhi, A.; Bornholdt, D.; Oeffner, F.; Malik, S.; Heid, E.; Happle, R.; Grzeschik, KH. (Aug 2004). "Multiple familial trichoepithelioma caused by mutations in the cylindromatosis tumor suppressor gene.". Cancer Res 64 (15): 5113-7. doi:10.1158/0008-5472.CAN-04-0307. PMID 15289313.
  3. URL: http://emedicine.medscape.com/article/1060049-workup#a0723. Accessed on: 31 August 2011.
  4. URL: http://emedicine.medscape.com/article/1060049-workup#a0723 Papillary-mesenchymal body (emedicine.medscape.com). Accessed on: 22 August 2012.
  5. URL: http://skinpathologyatlas.com/tumors/hair/trichofollic.htm. Accessed on: 22 August 2012.