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Trichoepithelioma: a 19‐year clinicopathologic re‐evaluation
Author(s) -
Bettencourt Miriam S.,
Prieto Victor G.,
Shea Christopher R.
Publication year - 1999
Publication title -
journal of cutaneous pathology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.597
H-Index - 75
eISSN - 1600-0560
pISSN - 0303-6987
DOI - 10.1111/j.1600-0560.1999.tb01864.x
Subject(s) - trichoepithelioma , basal cell carcinoma , calcification , pathology , stroma , medicine , basal cell , immunohistochemistry
Accurate histopathologie distinction between trichoepithelioma (TE) and basal cell carcinoma (BCC) may be challenging. From 97 cases diagnosed as TE during the period 1979–1997, 73 available cases were studied with regard to: 1) stroma; 2) retraction effect; 3) papillary‐mesenchymal bodies (PMB); 4) amyloid; 5) mitotic figures; 6) apoplotic cells; 7) inflammation; 8) granuloma; and 9) calcification. A judgment was made regarding diagnosis. The patients’medical records were subsequently reviewed for clinical features and possible recurrence. The diagnosis of TE was confirmed histologically in 48 (65%) of 73 cases. Fifteen cases (21%) were reclassified as BCC (RC‐BCC), eight other cases (11%) were reclassified as other lesions, and two additional cases (3%) could not be confidently classified as either TE or BCC. The most helpful differentiating features were the presence of retraction effect (in 100% of RC‐BCC vs. 37% of TE), myxoid stroma (in 80% of RC‐BCC vs. 12% of TE) and PMB (in 20% of RC‐BCC vs. 81% of TE). Unexpected findings in TE were detection of amyloid in 33%, apoplotic cells in 100%, and mitotic figures in 46%. Five of the 15 RC‐BCC have recurred (33%), whereas there have been no recurrences in the confirmed TE group. A constellation of hisiopathologic criteria may help lo discriminate problematic examples of trichoepithelioma from basal cell carcinoma.