Diaz-Cascajo Carlos, Borghi Susanna, Weyers Wolfgang, Bastida-Inarrea Jesus
Center for Dermatopathology, Postfach 1268, 79012 Freiburg, Germany.
J Cutan Pathol. 2004 Jan;31(1):19-25. doi: 10.1046/j.0303-6987.2004.0134.x.
In the last decades, a number of clinicopathologic subtypes of squamous cell carcinoma (SCC) of the skin, ranging from highly aggressive tumors with a tendency to recur and metastasize to neoplasms with a favorable prognosis, have been described. SCCs arising from the wall of hair follicles have been briefly mentioned by some authors but never reported in a series.
Cases of SCC arising from the wall of hair follicles were collected from the files of two large German Centers for Dermatopathology and analyzed clinicopathologically and immunohistochemically.
Sixteen cases of SCC developing in hair follicles were found among more than 7000 cases of cutaneous SCC reviewed. In most cases, tumors arose on sun-damaged skin of the face of elderly persons. There was a male predominance (11/5). The most common clinical diagnosis was basal cell carcinoma (BCC). Microscopically, tumors developed in the upper part of hair follicles without or with focal involvement of the overlying epidermis at the border with the involved follicle. Immunohistochemically, tumors were positive for cytokeratin and negative for a battery of immunomarkers, including antibodies against the most common carcinogenic human papillomaviruses (HPV) of the skin. Most tumors were excised by simple excision. In two cases, a recurrence was noted after incomplete excision. No further recurrences or metastasis have been noted after a follow-up period ranging from 11 months to 12 years.
SCC of the hair follicle represents a poorly recognized but distinctive subset of SCC of the skin that should be considered in the differential diagnosis of other cutaneous epithelial tumors. The term follicular SCC (FSCC) is proposed for this neoplasm.
在过去几十年中，已经描述了皮肤鳞状细胞癌（SCC）的多种临床病理亚型，从具有复发和转移倾向的高度侵袭性肿瘤到预后良好的肿瘤。一些作者曾简要提及毛囊壁来源的SCC，但从未有系列报道。
从德国两个大型皮肤病理学中心的档案中收集毛囊壁来源的SCC病例，并进行临床病理和免疫组化分析。
在超过7000例经审查的皮肤SCC病例中，发现了16例毛囊来源的SCC。大多数病例中，肿瘤发生在老年人面部受阳光损伤的皮肤上。男性居多（11/5）。最常见的临床诊断是基底细胞癌（BCC）。显微镜下，肿瘤发生在毛囊上部，在与受累毛囊交界处，其上覆表皮无或仅有局灶性受累。免疫组化方面，肿瘤细胞角蛋白阳性，一系列免疫标志物阴性，包括针对皮肤最常见致癌性人乳头瘤病毒（HPV）的抗体。大多数肿瘤通过单纯切除治愈。2例在切除不完全后出现复发。随访11个月至12年，未再发现复发或转移。
毛囊SCC是一种认识不足但独特的皮肤SCC亚型，在其他皮肤上皮肿瘤的鉴别诊断中应予以考虑。建议将此肿瘤命名为滤泡性SCC（FSCC）。
