BACKGROUND: The plaque variant of trichoblastoma has been described as a solitary tumor with diffuse infiltration of the lower dermis and hypodermis, with poorly defined borders. Herein, we report a new variant of multiple centrofacial trichoblastoma. OBJECT: To describe clinical and pathological features of a new multiple kind of plaque variant of centrofacial trichoblastoma. METHODS: Case series of patients with a multiple-plaque variant of centrofacial trichoblastoma treated in our department between 2005 and 2017. We identified eight patients with the centrofacial plaque variant of trichoblastoma treated in our department from 2005 to 2017. RESULTS: The final study sample comprised 13 trichoblastomas from four patients. All patients also developed at least one basal cell carcinoma. Mohs surgery was the method of treatment in the majority of the cases of trichoblastoma and in all the cases of basal cell carcinoma. We needed between 2 and 6 stages to obtain free margins in our cases of facial plaque trichoblastomas treated by Mohs surgery. CONCLUSION: To the best of our knowledge, a multiple-plaque variant of trichoblastoma has not been described in the literature. We suggest a genetic origin of this variant of trichoblastoma and describe its remarkable infiltrative nature, with poorly defined surgical margins.

• MeSH
• lidé středního věku MeSH
• lidé MeSH
• Mohsova operace MeSH
• nádory kůže patologie   chirurgie   MeSH
• nemoci vlasů patologie   chirurgie   MeSH
• obličej patologie   MeSH
• senioři MeSH
• vlasový folikul patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

We present the case of a 35-year-old man who developed a follicular differentiated cutaneous carcinoma with an eosinophil-rich infiltrate and an aggressive clinical behavior. After an in-depth histopathological investigation the diagnosis of trichoblastic carcinoma was made. Over the course of the disease the patient developed a cutaneous in-transit metastasis as well as an axillary lymph node metastasis 18 months after the excision of the primary tumor on his back. Based on a literature review we discuss the different concepts behind the term "trichoblastic carcinoma" and we summarize the clinical and histological details of previously reported cases. Furthermore, we focus on the phenomenon of tumor-associated eosinophilia.

• Klíčová slova
• eosinophil-rich infiltrate, follicular neoplasm, trichoblastic carcinoma,
• MeSH
• dospělí MeSH
• karcinom patologie   MeSH
• lidé MeSH
• lokální recidiva nádoru patologie   MeSH
• nádory kůže patologie   MeSH
• nemoci vlasů patologie   MeSH
• vlasový folikul patologie   MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• kazuistiky MeSH

BACKGROUND: Localized lymphedema is a nonneoplastic condition associated with obesity and predominantly involving the legs. This condition has distinctive clinical and histologic features and only rarely has been mentioned in the dermatologic literature. OBJECTIVE: We sought to evaluate the clinical and histopathologic features. METHODS: The clinicopathologic features in patients with localized lymphedema of the genital region were studied. RESULTS: We identified 18 patients with localized lymphedema clinically presenting as large polypoid or verrucous lesions. The patients were 5 men and 13 women with a mean age of 46.5 years. Twelve patients were obese at diagnosis. Thirteen patients presented with tumors involving the vulva, 4 patients with tumors in the penis and scrotum, and 1 patient with scrotal and pubic lesions. Histologically, all cases showed marked dermal edema along with dilated lymphatic spaces, fibroplasia, and verrucous epidermal changes (papillomatous and hyperplastic epidermis). LIMITATIONS: Only 18 cases were included in our study. CONCLUSIONS: This condition is an uncommon and recently described entity that could potentially be clinically and histologically misdiagnosed as a neoplasm; thus, it needs to be included in the differential diagnosis of polypoid and verrucous skin tumors with extensive dermal edema and fibroplasia.

• Klíčová slova
• localized lymphedema, massive localized lymphedema, penile lymphedema, scrotal lymphedema, vulvar lymphedema,
• MeSH
• dospělí MeSH
• edém komplikace   MeSH
• kožní nemoci komplikace   patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• lymfedém komplikace   patologie   MeSH
• nádory penisu komplikace   MeSH
• nádory vulvy komplikace   MeSH
• obezita komplikace   MeSH
• retrospektivní studie MeSH
• senioři MeSH
• skrotum MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Pigmented lesions in the anogenital area encompass a wide variety of disorders including squamous intraepithelial neoplasia. The authors sought to explore the mechanism(s) underlying clinically pigmented squamous intraepithelial neoplasia in the anogenital area. A light-microscopic and immunohistochemical study of 64 lesional specimens from 45 patients (32 women, 13 men; age range, 23-73 years) with pigmented lesions in the anogenital area was performed. Histopathologically, 63 (98%) specimens showed melanin incontinence into the superficial dermis beneath the dysplastic epithelium. A focal or total loss of basilar hyperpigmentation was detected in 30 (48%) and 13 (20%) of lesions, respectively. In 17 (27%) cases, absence of basal layer hyperpigmentation was accompanied by a subepithelial lichenoid infiltrate. Melanin within the upper part of dysplastic areas were seen in 63 cases (98%), whereas dendritic melanocytes colonization, mild in all but 1 specimen case, was observed in 53 (83%) cases. All cases proved to be the usual type of squamous intraepithelial neoplasia; no single case of the simplex (differentiated) variant was present. The main mechanisms of pigmented squamous intraepithelial neoplasia of the anogenital area include melanin incontinence and occurrence of melanin in dysplastic keratinocytes. Colonization of the dysplastic epithelium by dendritic melanocytes seems to contribute, but it is rarely a prominent feature.

• MeSH
• dospělí MeSH
• hybridizace in situ MeSH
• imunohistochemie MeSH
• karcinom in situ patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• melaniny MeSH
• melanocyty patologie   MeSH
• mladý dospělý MeSH
• nádory anu patologie   MeSH
• nádory mužských pohlavních orgánů patologie   MeSH
• nádory ženských pohlavních orgánů patologie   MeSH
• pigmentace kůže * MeSH
• polymerázová řetězová reakce MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• melaniny MeSH

BACKGROUND: Fibrolipomatous hamartoma of the nerve is a rare benign infiltrating condition of peripheral nerves with prominent cutaneous findings that has not being well described in the dermatologic and dermatopathologic literature. OBJECTIVE: We sought to evaluate the clinical and histopathological features of this rare condition. METHODS: We reviewed the clinicopathologic features of 13 cases to delineate their clinical presentation and histopathologic spectrum. RESULTS: All patients presented with unilateral lesions on the thenar areas, fingers, or both. In 7 cases the lesions presented congenitally and in 6 cases the lesions presented sporadically. Histologically, we found 2 patterns that have only been rarely mentioned before including cases with intraneural perineurioma-like features and cases with marked nerve hyperplasia. LIMITATIONS: Only 13 cases were included in our study. CONCLUSIONS: This condition is an uncommon entity. The diagnosis of this disorder can be highly suspected on its macroscopic features. Predilection of the median nerve and the frequent association with macrodactyly are characteristic clinical findings.

• Klíčová slova
• Proteus syndrome, fibrolipomatous hamartoma of the nerve, macrodactyly, median nerve, syndactylia,
• MeSH
• dítě MeSH
• dospělí MeSH
• hamartom komplikace   diagnóza   patologie   MeSH
• hodnocení rizik MeSH
• imunohistochemie MeSH
• jehlová biopsie MeSH
• lidé středního věku MeSH
• lidé MeSH
• lipom komplikace   diagnóza   patologie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory periferního nervového systému komplikace   diagnóza   patologie   MeSH
• prognóza MeSH
• prsty ruky abnormality   patologie   MeSH
• vrozené deformity končetin etiologie   patologie   MeSH
• vzácné nemoci MeSH
• vzorkové studie MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

Two unusual Carney complex patients are described. In one of them, several cutaneous biopsies revealed myxoid lesions that were rather more close to authentic adnexal neoplasms with myxoid stroma than to a "myxoma with an epithelial component." These included lesions resembling trichofolliculoma, infundibular cyst, and trichodiscoma. Additionally, 1 soft tissue myxoma was unique in the sense that it greatly resembled a cardiac myxoma, begging the question whether this could represent an embolus from the patient's cardiac myxoma. Given the large size and complexity and heterogeneity of the cutaneous lesions, the authors suggest that these may represent authentic cutaneous neoplasms accompanied by myxoid stroma and not adnexal elements induced by the stroma. However, the latter mechanism is well recognized and demonstrated by our second patient in whom adnexal-type elements in the cutaneous lesion were clearly induced by the myxoid stroma but were unusually complex by manifesting panfollicular and also sebaceous differentiation.

• MeSH
• biopsie MeSH
• buněčná diferenciace MeSH
• buňky stromatu patologie   MeSH
• Carneyův komplex genetika   patologie   MeSH
• dospělí MeSH
• lidé MeSH
• mutace MeSH
• mutační analýza DNA MeSH
• nádory kožních adnex genetika   patologie   MeSH
• nádory kůže genetika   patologie   MeSH
• nádory měkkých tkání genetika   patologie   MeSH
• proteinkinasy závislé na cyklickém AMP, podjednotka RIalfa genetika   MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• Názvy látek
• PRKAR1A protein, human MeSH Prohlížeč
• proteinkinasy závislé na cyklickém AMP, podjednotka RIalfa MeSH

Mixed tumor, eccrine type, is a rare cutaneous adnexal neoplasm, mostly reported as isolated case reports. A systematic analysis of its histopathologic and immunohistochemical features has not previously been performed on a large series. The purpose of our investigation was to study a large number of cutaneous eccrine mixed tumors so as to fully characterize the entire spectrum of changes in the epithelial and stromal components, with an emphasis on unusual histopathologic features that may represent a diagnostic pitfall. This article reports a light microscopic and immunohistochemical study of 50 cases of eccrine mixed tumor, complemented by a literature review. Our study identified some unusual histopathologic features, thus extending the morphologic spectrum of this neoplasm. These included prominent cribriform areas, clear cell change, pseudorosette structures, prominent osseous metaplasia, and physaliphorous-like cells. Most of these features have not been previously recorded in eccrine mixed tumors and may represent a potential diagnostic pitfall.

• MeSH
• dospělí MeSH
• ekrinní žlázy metabolismus   patologie   MeSH
• imunohistochemie metody   MeSH
• lidé středního věku MeSH
• lidé MeSH
• maligní smíšený nádor metabolismus   patologie   MeSH
• mladý dospělý MeSH
• nádorové biomarkery metabolismus   MeSH
• nádory kožních adnex metabolismus   patologie   MeSH
• nádory kůže metabolismus   patologie   MeSH
• nádory potních žláz metabolismus   patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH
• přehledy MeSH
• Názvy látek
• nádorové biomarkery MeSH

Syringocystadenocarcinoma papilliferum is an extremely rare cutaneous adnexal neoplasm. The purpose of our investigation was to study a series of syringocystadenocarcinoma papilliferum to document morphologic variations of the neoplasm. This is a light-microscopic study of 6 cases of syringocystadenocarcinoma papilliferum obtained from the combined archival, institutional, and consultations files of the authors over 60 years, complemented by a literature review. Syringocystadenocarcinoma papilliferum invariably occurred in association with syringocystadenoma papilliferum and presented as an in situ adenocarcinoma and/or invasive adenocarcinoma. Additionally, an invasive component was represented by squamous cell carcinoma. Variable present features included pagetoid migration of the neoplastic cells, dirty necrosis, mucinous ductal metaplasia, and ductal changes analogous to those seen in the breast. The ductal changes included patterns identical to columnar cell change (flat epithelial atypia), usual ductal hyperplasia, atypical ductal hyperplasia, and ductal carcinoma in situ. A combination of the above patterns in a single lesion was noted. It is concluded that morphologic diversity of syringocystadenocarcinoma papilliferum is substantial. Its association with the benign counterpart and ductal changes suggests a transformation that may involve usual ductal hyperplasia-atypical ductal hyperplasia-(ductal) adenocarcinoma in situ-invasive adenocarcinoma pathway.

• MeSH
• adenom potní žlázy patologie   MeSH
• cystadenokarcinom papilární patologie   MeSH
• duktální karcinom patologie   MeSH
• karcinom in situ patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory potních žláz patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• spinocelulární karcinom patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• přehledy MeSH

Gigantic cutaneous horns, grossly similar to the horns seen in animals, are exceedingly rare in humans. After finding one case in practice, we searched our departmental files for similar cases and examined them grossly and microscopically. Four cases were identified. All occurred as solitary lesions in older women on the parietal-occipital region of the scalp. They had a growth history of up to 30 years; the women hid these horns in their hair. Grossly, the horns were yellow-grey, and there were shallow furrows running along the length of the horns. The length ranged from 17 to 25 cm, and the width was up to 2.5 cm. All four lesions showed similar histologic changes. Microscopically, the gigantic horns consisted of a mixture of squamous epithelial cells and tricholemmal keratinized debris. In one case the base of the horn was directly connected with a mass composed of benign tricholemmal cysts of the scalp. Mitoses were common, but atypical mitoses were not observed. The nuclei of the squamous cells were bland without pleomorphism, hyperchromasia, or atypia. Follow-up of all patients was uneventful: all patients were well and without signs of recurrence or metastasis 2-15 years after the surgical excision. Gigantic cutaneous horns are rare and benign. We think that they represent an extremely well-differentiated variant of proliferating tricholemmal tumor with an unusual and remarkable gross pattern.

• MeSH
• cysty patologie   chirurgie   MeSH
• dermatózy skalpu patologie   chirurgie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory kůže patologie   chirurgie   MeSH
• rohy anatomie a histologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• skalp patologie   MeSH
• skot MeSH
• zvířata MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• skot MeSH
• ženské pohlaví MeSH
• zvířata MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH