Fibroepithelial polyp

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Fibroepithelial polyp
Diagnosis in short

Fibroepithelial polyp. H&E stain.

LM On a stalk / epithelium on three sides, benign epidermis, fibrous core, +/-inflammation
LM DDx Regressing melanocytic lesions (esp. intradermal melanocytic nevus), pedunculated seborrheic keratosis, nevus lipomatosus superficialis, neurofibroma
Gross raised skin-coloured lesion
Site skin

Syndromes Birt–Hogg–Dubé syndrome

Prevalence very common
Prognosis benign

Fibroepithelial polyp, also known as acrochordon and skin tag, is a very common benign skin lesion.

The lesion in the mouth is dealt with in the article oral fibroma.

General

May be divided into:

  • Epithelial type - abundant epithelium.
  • Stromal type - abundant fibrous stroma.

Gross

  • Raised skin-coloured lesion.

DDx - clinical:

  • Skin tag-like nevus.

Image

Microscopic

Features:

  • On a stalk / epithelium on three sides.
  • Benign epidermis.
  • Fibrous core.
  • +/-Inflammation.

DDx:

Images

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EYELID ("TAG"), RIGHT, REMOVAL:
- BENIGN FIBROEPITHELIAL POLYP.
SKIN ("SKIN TAG"), THIGH, REMOVAL:
- FIBROEPITHELIAL POLYP.

Micro

The sections show a fragment of skin with epithelium on three sides. The epithelium matures normally and is not hypertrophic. Orthokeratosis is present. The core of the lesion has fibrous tissue. There is no significant inflammation. No melanocytic nests are identified.

Hyperkeratosis

The sections show a fragment of skin with epithelium on three sides. The epidermis matures toward the surface and no significant basilar atypia is identified. A prominent granular layer is present. Mild hyperkeratosis is present. The core of the lesion consists of fibrous tissue. There is no significant inflammation. No melanocytic nests are identified.

Inflamed

The sections show a fragment of skin with epithelium on three sides. The epithelium matures and is acanthotic. Minimal parakeratosis is present. The core of the lesion consists of fibrous tissue with a mild lymphocyte-predominant dermal infiltrate. Rare siderophages are present.

There is mild basal nuclear enlargement. No significant nuclear atypia is apparent. The dermal-epidermal interface is well-demarcated. Rare basal mitotic activity is identified.

Epithelial-type

The sections show skin with epithelium on three sides, acanthosis and hyperkeratosis. No pseudohorn cysts are identified. A granular layer is present. Mild basal nuclear atypia is present. Mitotic activity is present but basal. Minimal parakeratosis is present. No melanocytic nests are identified. No solar elastosis is apparent in the limited dermis. No koilocytes are apparent.

See also

References

  1. 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. 596. ISBN 978-1416054542.
  2. Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 342. ISBN 978-0443066542.
  3. URL: http://dermatlas.med.jhmi.edu/derm/result.cfm?Diagnosis=1196583692. Accessed on: 1 September 2011.
  4. URL: http://dermatology-s10.cdlib.org/143/case_presentations/skintags/allegue.html. Accessed on: 9 January 2013.