摘要:

Pilomatrixoma, a neoplasm of hair germ matrix origin, is one of the most common cutaneous appendage tumors in patients 20 years of age or younger. Our review of cutaneous adnexal tumors in the first 2 decades of life showed that pilomatric lesions accounted for ∼75% of cases. We examined 76 tumors from 69 patients between the ages of 8 months and 19 years (average age, 8 years). The femaleto-male ratio was 3:1. We noted a predilection for the head and neck region, as has also been reported by other investigators. Sixty-nine tumors were examples of typical or classic pilomatrixoma; four of them showed the unusual histologic feature of transepidermal elimination or perforation. None of the tumors in the typical category recurred during a follow-up period that averaged 8.7 years. Seven of the lesions with atypical histologic features were examples of aggressive pilomatrixoma (three cases) and pilomatrical carcinoma (four cases). The average age of these seven patients was similar to that of the overall group. The pilomatrical carcinomas were characterized by invasive nests of tumor cells with irregular borders, large vesicular nuclei, prominent nucleoli, multiple mitotic figures, and focal necrosis. A desmoplastic stroma surrounded the infiltrating nests of tumor. Two of the four pilomatrical carcinomas recurred 2 and 6 months, respectively, after initial excision. The aggressive piloma trixomas had a similar infiltrative growth pattern, but they did not exhibit the same degree of worrisome cytologic features. Single cell necrosis, identifiable mitotic figures, and prominent nucleoli differentiated the atypical from the typical pilomatrixomas. One of the three aggressive pilomatrixomas recurred after 2 months. Tumors of hair germ matrix or pilar derivations show a spectrum of pathologic findings that correlate with prognosis.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Cutaneous T-cell lymphomas (CTCLs) are known to show monoclonal T-cell infiltrates late in the course of the disease. However, detection of monoclonal T-cell proliferation in early stages is difficult. To investigate the possibility that clones might appear only as minor subpopu lations. we analyzed the proliferative activity of T cells expressing certain variable (V) regions of the T-cell receptor (TCR). In biopsy specimens from 27 patients with CTCLs, all T cells expressing the V regions Vα2. Vβ5a, Vβ5b, Vβ6, Vβ8. and Vβ12 accounted for <5% of the total infiltrate. In the vast majority of the cases, <3% of the cells expressing one TCR V region proliferated. In one case of mycosis fungoides, however, an epidermo tropic clone expressing Vβ8 was detected. This clone was present in two distinct lesions from different anatomic sites and was found in an early relapse 1 year after complete remission following PUVA therapy. The case described here documents the possibility of clonal disease early in the course of mycosis fungoides.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Eight angiosarcomas were clinicopathologically and immunohistochemically investigated. Four of the angiosarcomas originated in the scalp of the elderly, and four cases were angiosarcomas associated with chronic lymphedema after hysterectomy for uterine carcinoma or after mastectomy for breast carcinoma. Six of the angiosarcomas showed conventional histopathology, whereas the remaining two cases were considered cutaneous epithelioid angiosarcoma. Immunohistochemical studies for blood group antigens ABH were carried out. Three of the conventional angiosarcomas were weakly positive and three were moderately positive with antigens ABH. The antigens were strongly positive in the two epithelioid angiosarcomas. The biologic course of the two epithelioid angiosarcomas was longer than that of the other six cases. This study suggested that the strong positivity of blood group antigens may be one of the characteristics of epithelioid angiosarcoma.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Seven cases of desmoplastic trichilemmoma (DT). a recently described pseudomalignant variant of trichilemmoma, are reviewed. The tumor generally occurs in men after the fifth decade of life and presents as a small solitary nodule on the face. It is frequently misdiagnosed clinically as a basal cell carcinoma or a papilloma. Histologically DT displays a superficial lobular growth arranged about a central prominent desmoplastic stroma. At the periphery, the tumor lobules show the typical features of trichilemmoma. In contrast, at the center the cells assume a more random pattern of cords and strands traversed by the hyaline stroma, mimicking invasive carcinoma. The tumor's architectural pattern, in particular the perilobular hyaline mantle, enables DT to be differentiated from basal cell carcinoma and malignant trichilemmoma. Immunohistochemical analysis failed to demonstrate human papilloma virus (HPV), epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), and alpha-lactalbumin in tumor epithelium. Keratin was expressed by the central pseudoinvasive epithelial cords. Neither factor Xllla nor keratin expression was found in the stromal cells, which stained only for vimentin. These findings suggest that DT is not an HPV-induced epithelial proliferation and that the stroma is not the result of degenerative changes in tumor epithelium. Instead, there appears to be a fibroblast-mediated, dendrocyte independent, stromal reaction producing this appearance.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

The distribution of cytokeratin (CK) polypeptides expressed in syringomas (12 cases) was compared with that in normal eccrine sweat ducts using immunohistochemical techniques on paraffin-embedded tissue. Intradermal and intraepidermal segments of the eccrine duct showed reactivity with an antibody to CK 1/5/10/11 in all cell layers, whereas CK19 expression was restricted to the luminal cell layer. CK14 was expressed in all cells of the eccrine duct except for the peripheral cells of the intraepidermal duct. Expression of CK5/6 was seen in the basal cells of the dermal duct and of the lower intraepidermal duct (sweat duct ridge) exclusively. Reactivity with an antibody to CK1 was found in the intermediate cells of the uppermost part of the eccrine dermal duct. In addition, this antibody gave a strong staining of the peripheral cells of the intraepidermal duct, leaving basal cells of the sweat duct ridge and luminal cells unstained. In syringoma, CK distribution was essentially comparable with that found in the uppermost part of the dermal duct and in the sweat duct ridge. Namely, ductal luminal cells expressed CK1/5/10/11, CK19, and variably CK14. Intermediate cells of ductal structures and solid nests were homogeneously stained by antibodies to CK1 and CK1/5/10/11, whereas CK14 was expressed heterogeneously. The basal or outermost layer of ductal structures and solid nests was reactive with antibodies to CK1/5/10/11, CK5/6, and CK14. With regard to CK expression, the results indicate that syringoma represents a tumor differentiating toward both the uppermost part of the dermal duct and the lower intraepidermal duct (sweat duct ridge) of the eccrine sweat gland.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

On the basis of a study of 54 specimens each of large-cell acanthoma, solar lentigo, reticulated seborrheic keratosis, and lichen planus-like keratosis, it is concluded that clinically, histopathoiogically, and biologically, large-cell acanthoma is a variant of solar lentigo, and solar lentigo (including the large-cell variant) is a stage in the evolution of reticulated seborrheic keratosis and of lichen planus like keratosis.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

摘要:

Large-cell acanthoma is an epidermal neoplasm that is clinically, histologically, and biologically distinctive. Clinically, it differs from solar lentigo by being frequently skin-colored or hypopigmented. Histologically, it is defined by a population of uniformly large keratinocytes; it differs from solar lentigo by the absence of elongated hyperpigmented and sometimes hockey stick-shaped buds of keratinocytes. Biologically, it consists of hyperploid keratinocytes, whereas solar lentigo consists of diploid keratinocytes. Although the exact nosologic status of this entity is still controversial, its features are distinctive enough for the term “large-cell acanthoma” to merit continued usage.

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID

ISSN:0193-1091    

出版商:OVID    

年代:1992

数据来源: OVID