Pilomatricoma, also known as Pilamatrixoma or Malherbe's calcifying epithelioma, is a benign skin tumour with a bimodal age distribution between the paediatric and elderly age groups. Although it was previously thought to be rare, recent studies have revealed that it is quite common. Typically, pilomatricoma is diagnosed following histopathological examination of the lesion as it is frequently misdiagnosed with other types of skin pathology. In our case, the child presented with painless swelling of the left infraauricular region. The initial cytology and imaging were unable to provide a definite diagnosis. An excision biopsy was done, and a histopathological examination was suggestive of Pilomatricoma. Therefore, Pilomatricoma ought to be considered in the differential diagnosis of head and neck lesions in hopes of providing a better understanding on this pathological lesion.

• Klíčová slova
• benign mass, epithelioma of Malherbe, pilomatricoma, pilomatrixoma,
• MeSH
• biopsie MeSH
• chybná diagnóza MeSH
• dítě MeSH
• lidé MeSH
• nádory kůže * diagnóza   patologie   MeSH
• nemoci vlasů * diagnóza   chirurgie   patologie   MeSH
• pilomatrixom * diagnóza   chirurgie   patologie   MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• lidé MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH

Trichoblastoma (TB) is a benign biphasic follicular neoplasm with differentiation toward the germinative cells and a specific follicular mesenchyme. We subtyped 349 sporadic TB according to a classification proposed by Ackerman. Two hundred forty-six (246/349, 70.5%) neoplasms were comprised of mixed subtypes. TB composed exclusively of a single pattern was less common (103/349, 29.5%). The most common pure subtype was cribriform TB followed by small nodular TB. Twelve cases (12/349, 3.4%) had unique features and are reported herein as novel histopathologic subtypes of the neoplasm.

• MeSH
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory kožních adnex patologie   MeSH
• nádory kůže patologie   MeSH
• nemoci vlasů patologie   MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vlasový folikul patologie   MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

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

Basal cell carcinoma (BCC) with matrical differentiation is a fairly rare neoplasm, with about 30 cases documented mainly as isolated case reports. We studied a series of this neoplasm, including cases with an atypical matrical component, a hitherto unreported feature. Lesions coded as BCC with matrical differentiation were reviewed; 22 cases were included. Immunohistochemical studies were performed using antibodies against BerEp4, β-catenin, and epithelial membrane antigen (EMA). Molecular genetic studies using Ion AmpliSeq Cancer Hotspot Panel v2 by massively parallel sequencing on Ion Torrent PGM were performed in 2 cases with an atypical matrical component (1 was previously subjected to microdissection to sample the matrical and BCC areas separately). There were 13 male and 9 female patients, ranging in age from 41 to 89 years. Microscopically, all lesions manifested at least 2 components, a BCC area (follicular germinative differentiation) and areas with matrical differentiation. A BCC component dominated in 14 cases, whereas a matrical component dominated in 4 cases. Matrical differentiation was recognized as matrical/supramatrical cells (n=21), shadow cells (n=21), bright red trichohyaline granules (n=18), and blue-gray corneocytes (n=18). In 2 cases, matrical areas manifested cytologic atypia, and a third case exhibited an infiltrative growth pattern, with the tumor metastasizing to a lymph node. BerEP4 labeled the follicular germinative cells, whereas it was markedly reduced or negative in matrical areas. The reverse pattern was seen with β-catenin. EMA was negative in BCC areas but stained a proportion of matrical/supramatrical cells. Genetic studies revealed mutations of the following genes: CTNNB1, KIT, CDKN2A, TP53, SMAD4, ERBB4, and PTCH1, with some differences between the matrical and BCC components. It is concluded that matrical differentiation in BCC in most cases occurs as multiple foci. Rare neoplasms manifest atypia in the matrical areas. Immunohistochemical analysis for BerEP4, EMA, and β-catenin can be helpful in limited biopsy specimens. From a molecular biological prospective, BCC and matrical components appear to share some of the gene mutations but have differences in others, but this observation must be validated in a large series.

• MeSH
• bazocelulární karcinom genetika   metabolismus   mortalita   patologie   MeSH
• buněčná diferenciace MeSH
• dospělí MeSH
• imunohistochemie MeSH
• lidé středního věku MeSH
• lidé MeSH
• mutace MeSH
• nádorové biomarkery genetika   metabolismus   MeSH
• nádory kůže genetika   metabolismus   mortalita   patologie   MeSH
• následné studie MeSH
• nemoci vlasů genetika   metabolismus   mortalita   patologie   MeSH
• pilomatrixom genetika   metabolismus   mortalita   patologie   MeSH
• prognóza MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• vysoce účinné nukleotidové sekvenování MeSH
• Check Tag
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• nádorové biomarkery MeSH

One hundred cases of trichoblastomas (large nodular, small nodular, cribriform, lymphadenoma, and columnar) were randomly selected and studied for the presence of melanocytic hyperplasia in the epidermis overlying the tumors, which was defined as foci of increased melanocytes in the basal layer of the epidermis (more than 1 per 4 basal keratinocytes). Focal melanocytic hyperplasia was detected in a total of 22 cases of trichoblastoma (22%), and this phenomenon was most frequently seen in columnar trichoblastoma (7 cases), followed by large nodular trichoblastoma (5 cases). The mechanism of epidermal melanocytic hyperplasia overlying trichoblastoma is unclear. Ultraviolet may be a contributing factor, as focal melanocytic hyperplasia was also detected in one-third of cases in the epidermis overlying uninvolved skin, usually associated with solar elastosis. This is further corroborated by the occurrence of the lesions predominantly on the face. Melanocytic hyperplasia overlying trichoblastoma appears to have no impact on the clinical appearance of the lesion and is recognized only microscopically. In an adequate biopsy specimen containing at least part of trichoblastoma, it should not cause any diagnostic problems.

• MeSH
• dítě MeSH
• dospělí MeSH
• epidermis patologie   MeSH
• hyperplazie patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• melanocyty patologie   MeSH
• mladiství MeSH
• mladý dospělý MeSH
• nádory kožních adnex patologie   MeSH
• nemoci vlasů patologie   MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• Check Tag
• dítě MeSH
• dospělí MeSH
• lidé středního věku MeSH
• lidé MeSH
• mladiství MeSH
• mladý dospělý MeSH
• mužské pohlaví MeSH
• předškolní dítě MeSH
• senioři nad 80 let MeSH
• senioři MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

A rare skin tumor (melanocytic matricoma), 6 mm in diameter, was diagnosed on the skin of the back in a 66-year-old man. It was composed of two cellular types: 1. epithelial cells with hair follicle differentiation and 2. dendritic melanocytes. After two years of follow-up there are no signs of a relapse or generalisation of the tumor.

• Klíčová slova
• melanocytic matricoma - tumors of hair follicle - adnexal skin tumors - matricoma.,
• MeSH
• buněčná diferenciace MeSH
• kůže patologie   MeSH
• lidé MeSH
• melanocyty patologie   MeSH
• nádory kůže patologie   MeSH
• nemoci vlasů patologie   MeSH
• pilomatrixom patologie   MeSH
• senioři MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH

The authors report an unusual case of intrafollicular collagenous crystalloids in an 86-year-old woman. The presence of collagenous crystalloids within the follicular epithelium is intriguing and has not been described previously.

• MeSH
• diferenciální diagnóza MeSH
• isotonické roztoky analýza   MeSH
• kolagen analýza   metabolismus   MeSH
• krystalizace MeSH
• krystaloidní roztoky MeSH
• lidé MeSH
• nádory kůže diagnóza   MeSH
• nemoci vlasů metabolismus   patologie   MeSH
• nos MeSH
• senioři nad 80 let MeSH
• spinocelulární karcinom diagnóza   MeSH
• vlasový folikul chemie   metabolismus   patologie   MeSH
• Check Tag
• lidé MeSH
• senioři nad 80 let MeSH
• ženské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH
• Názvy látek
• isotonické roztoky MeSH
• kolagen MeSH
• krystaloidní roztoky MeSH

We present a case of microcystic adnexal carcinoma (MAC) occurring on the upper lip of a 63-year-old man, which, in addition to the predominant areas of a conventional MAC, manifested multiple foci of follicular differentiation resulting in trichoblastomatous appearances. Some areas were highly reminiscent of desmoplastic trichoepithelioma (columnar trichoblastoma). We also reviewed 24 cases of MAC in our files, but in none of the cases were similar features observed, indicating that such histopathological findings are rare in MAC.

• MeSH
• karcinom kožních adnex patologie   MeSH
• lidé středního věku MeSH
• lidé MeSH
• nádory kůže patologie   MeSH
• nemoci vlasů patologie   MeSH
• ret MeSH
• vlasový folikul patologie   MeSH
• Check Tag
• lidé středního věku MeSH
• lidé MeSH
• mužské pohlaví MeSH
• Publikační typ
• časopisecké články MeSH

A case of low-grade trichoblastic carcinosarcoma was reported in 2004. Here we present the second case of this tumor, which, in contrast to the original example, may be classified as a high-grade neoplasm. A 92-year-old man presented with an ulcerated lesion on the left ear. The tumor was excised, and the patient had no evidence of recurrence or metastasis 6 years after surgery. Microscopically, the neoplasm demonstrated a fenestrated growth pattern with a slightly myxoid matrix in the background. Two clear components were identified: the first component was clearly epithelial with formation of small round nests, lobules, delicate strands, and small cribriform structures of basaloid cells with some degree of peripheral palisading, nuclear atypia, focal nuclear crowding, and frequent mitotic figures including abnormal forms. Each epithelial aggregation was invariably surrounded by one to three rows of cells with oval to round nuclei, which appeared very similar to specific trichogenic stroma seen in anagen follicles or in trichoblastomas; however, these stromal cells manifested atypical mitoses and cellular pleomorphism. The epithelial and stromal units frequently formed structures identical to follicular papillae associated with germs or "continuous germs" contiguous with "continuous papillae." Despite the close association throughout the tumor, the epithelial and the stromal cells were sharply separated, without transition between both elements. In foci, these stromal cells lost their follicular papillae-like arrangement and proliferated in a diffuse fashion and gradually blended with highly pleomorphic mononuclear spindle-shaped cells and bizarre multinucleated cells that grew in sheets in a highly vascular stroma. Immunohistochemically, the epithelial component showed diffuse staining for cytokeratins (AE1/AE3) and was negative for vimentin and CAM5.2. The stromal cells were positive for vimentin and negative for cytokeratin markers (AE1/AE3) and desmin. We view the present case and that previously reported in 2004 as authentic carcinosarcomas, and not as metaplastic (sarcomatoid) basal cell carcinomas. This conclusion is reached after analyzing the embryological development of the hair follicle, its normal histology and the morphology of cutaneous adnexal tumors with follicular differentiation.

• MeSH
• bazocelulární karcinom patologie   MeSH
• diferenciální diagnóza MeSH
• imunohistochemie MeSH
• karcinosarkom metabolismus   patologie   MeSH
• lidé MeSH
• nádory kožních adnex metabolismus   patologie   MeSH
• nádory kůže metabolismus   patologie   MeSH
• nemoci vlasů metabolismus   patologie   MeSH
• senioři nad 80 let MeSH
• ucho patologie   MeSH
• vlasový folikul patologie   MeSH
• Check Tag
• lidé MeSH
• mužské pohlaví MeSH
• senioři nad 80 let MeSH
• Publikační typ
• časopisecké články MeSH
• kazuistiky MeSH