Swick Brian L, Baum Christian L, Walling Hobart W
Department of Dermatology and Pathology, University of Iowa, Iowa City, USA.
J Cutan Pathol. 2009 Nov;36(11):1200-5. doi: 10.1111/j.1600-0560.2009.01258.x.
A 36-year-old man developed a papular growth in a portion of a nevus sebaceus on the post-auricular scalp. Excision showed typical histologic changes of nevus sebaceus including epidermal papillomatosis with reduced numbers of hair follicles as well as numerous sebaceous glands high in the dermis that focally emptied directly to the overlying epidermis. Histologic sections of the papular growth at the superior pole of the nevus sebaceus showed a proliferation of cytologically bland basaloid epithelial tumor lobules both in the superficial dermis, with multiple connections to the epidermis, and within the deeper dermis in a nodular growth pattern demonstrating papillary mesenchymal bodies. Ductal structures with apocrine-type decapitation secretion were present. There was prominent palisading of nuclei in rows parallel to one another, alternating with bands of homogenous eosinophilic stromal material forming a ripple pattern resembling the Verocay bodies of schwannoma. The histologic features resembled those of rippled-pattern trichoblastoma with apocrine differentiation arising in a nevus sebaceus, an association not previously described. We discuss this case as well as review the literature on rippled-pattern trichoblastoma.
一名36岁男性在耳后头皮的皮脂腺痣部位出现了一个丘疹样肿物。切除标本显示皮脂腺痣的典型组织学改变，包括表皮乳头瘤样增生，毛囊数量减少，真皮浅层有大量皮脂腺，部分皮脂腺直接通向覆盖其上的表皮。皮脂腺痣上极丘疹样肿物的组织学切片显示，在真皮浅层有细胞学表现温和的基底样上皮肿瘤小叶增生，与表皮有多处相连，在真皮深层呈结节状生长模式，可见乳头间充质体。存在具有顶泌汗腺型断头分泌的导管结构。细胞核呈显著的平行排列栅栏状，与均匀嗜酸性基质带交替出现，形成类似神经鞘瘤Verocay小体的波纹状图案。组织学特征类似于皮脂腺痣中出现的具有顶泌汗腺分化的波纹状毛母细胞瘤，这种关联此前未见报道。我们讨论该病例并回顾关于波纹状毛母细胞瘤的文献。
