FOLLICULAR TUMORS Flashcards
Identify the pointed structures
STEM / SUPRABULBAR AREA
Identify the pointed structures
Isthmus
Trichilemmal keratinization - without granular layer
Infundibulum - lined by epithelium identical to the epidermis; (+) granular layer
follicular tumors with infundibulum differentiation
- Trichoadenoma
- Dilated pore of winer
- Folliculo-sebaceous cystic hamartoma (FSCH)
Follicular tumors with Outer root sheath/ trichilemmomal differentiation
- Inverted follicular keratosis
- Pilar sheath acanthoma
- Trichilemmoma
- Trichilemmal/ pilar cyst
- Proliferating trichilemmal/ pilar cyst
Follicular tumor with hair matrix differentiation
Pilomatricoma
- central crater keratinizes through a granular layer
- smaller bluish projecting epithelial buds
- central crater keratinizes through a granular layer
- Bigger buds than that of dilated pore; w/ isthmic character;
- (+/-) duct.
- Central cystic structure that opens to the skin; with infundibular differentiation .
- Smaller secondary mature or immature/abortive follicles radiate out into the dermis. (Inferior segment differentiation)
- Interfollicular bridges connect radiating follicular structures
- Surrounding Stroma: fibrotic & “encapsulates” the neoplasm
DILATED PORE (of WINER)
PILAR SHEATH ACANTHOMA
TRICHOFOLLICULOMA
- CATEGORY: CYSTS
- Dermal-based cyst
- Lined by stratified squamous epithelium WITHOUT a granular layer
- Central abrupt compact keratinization (trichilemmal differentiation)
- Epithelial lining resembles isthmus follicular outer root sheath
- no koilocytes
TRICHILEMMOMA
- Multiple trichilemmoma – a major criterion for Cowden’s syndrome.
- a wart-like silhouette; hyperkeratosis, hypergranulosis, even epidermal colarette,
- thickened epithelium w/ bulbous lobular contour
- pale or clear cells;
- peripheral palisading at the outer margin
- thick basement membrane.
- (+/-) squamous eddies and microcysts
Multiple trichilemmoma is seen in what syndrome
Cowden’s Syndrome
Trichoblastoma
How can you differentiate TRICHOBLASTOMA (TB) / TRICHOEPITHELIOMA (TEP) VS BCC
SYNDROMES WITH TRICHOBLASTOMAS/ TRICHOEPITHELIOMAS
- Brooke Fordyce syndrome: multiple trichoblastomas
- Brooke Spiegler Syndrome: Spiradenomas, cylindromas, and trichoepitheliomas (cribriform trichoblastomas)
- Rombo syndrome: Atrophoderma vermiculata, milia, hypotrichosis, BCC, trichoepitheliomas, peripheral cyanosis
- Bazex syndrome: : Atrophoderma vermiculata, hypotrichosis, hypohidrosis, trichoepitheliomas, BCC.
- Gardner’s Syndrome: Epidermoid cysts, desmoid tumors, multiple trichoepitheliomas, fibromas, lipomas, leiomyomas, osteomas
- Rassmusen’s syndrome: Trichoepitheliomas, milia and cylindromas
- Multiple Familial Trichoepithelioma*
most frequent benign secondary lesion arising from Nevus sebaceus
Syringocystadenoma papilliferum followed by trichoblastoma
Most common malignant lesion arising from nevus sebaceus
BCC
