Swanson P E, Marrogi A J, Williams D J, Cherwitz D L, Wick M R
Lauren V. Ackerman Laboratory of Surgical Pathology, Washington University, School of Medicine, St. Louis, MO.
J Cutan Pathol. 1992 Apr;19(2):100-9. doi: 10.1111/j.1600-0560.1992.tb01350.x.
Tricholemmal carcinoma (TLC) is a cutaneous adnexal tumor with presumed external hair sheath differentiation. In order to better understand the salient features of this neoplasm, we analyzed the histologic and clinical findings in 10 cases of TLC. Eight patients were males, and two were female; they ranged in age from 55-88 years. Each tumor occurred in hair bearing, sun-exposed skin, and involved the scalp, face, trunk, or upper extremities. The lesions were usually slightly raised, pale tan or reddish, and keratotic; were usually present for less than 1 year; and measured 0.4-2.0 cm. All of them were treated by wide local excision; neither recurrence nor metastasis was reported after 11 to 92 months of clinical followup. Histologically, each TLC was composed of a lobular proliferation centered on the pilar apparatus. Cells with glycogen-rich, mucin-negative, clear or pale eosinophilic cytoplasm predominated. Brisk mitotic activity (4-39 mitoses per 10 high power fields) was typical. Involvement of the interfollicular epidermis was invariably noted, with superficial ulceration in seven tumors. Transitional zones between TLC and the adjacent epidermis were not seen, although pagetoid spread occurred in two examples. Invasion of reticular dermis was present in eight cases, with infiltration to mid-dermis in five TLC. All tumors exhibited areas of tricholemmal type keratinization; dyskeratotic cells were noted in six examples. Hyperkeratosis and parakeratosis were variably present as well. Actinic damage was a constant feature. Despite local invasion at diagnosis, the clinical course of TLC was indolent in all cases.
毛鞘癌（TLC）是一种推测具有外毛鞘分化的皮肤附属器肿瘤。为了更好地了解这种肿瘤的显著特征，我们分析了10例TLC的组织学和临床 findings。8例患者为男性，2例为女性；年龄范围为55 - 88岁。每个肿瘤均发生于有毛发、暴露于阳光的皮肤，累及头皮、面部、躯干或上肢。病变通常轻微隆起，呈淡褐色或红色，且有角化；通常存在时间少于1年；大小为0.4 - 2.0厘米。所有病例均接受了广泛局部切除治疗；临床随访11至92个月后，均未报告复发或转移。组织学上，每个TLC均由以毛囊结构为中心的小叶状增生组成。以富含糖原、黏液阴性、透明或淡嗜酸性细胞质的细胞为主。典型表现为有活跃的有丝分裂活性（每10个高倍视野有4 - 39个有丝分裂）。总是可见累及毛囊间表皮，7个肿瘤有浅表溃疡。尽管在2个病例中出现了派杰样扩散，但未见到TLC与相邻表皮之间的过渡带。8例病例存在网状真皮浸润，5例TLC浸润至真皮中层。所有肿瘤均有毛鞘型角化区域；6例可见角化不良细胞。角化过度和不全角化也有不同程度的存在。光化损伤是一个持续特征。尽管在诊断时存在局部浸润，但所有病例中TLC的临床病程均呈惰性。
