Starink T M, Meijer C J, Brownstein M H
J Cutan Pathol. 1985 Apr;12(2):83-93. doi: 10.1111/j.1600-0560.1985.tb01607.x.
Histological, histochemical and immunohistochemical findings were studied in 40 cutaneous biopsies from 7 patients with Cowden's disease. Most facial biopsies showed a spectrum of trichilemmomas and related follicular malformations, including cylindrical trichilemmomas, lobulate trichilemmomas (14 lesions), and a keratinizing type sharing features with inverted follicular keratosis. One facial growth showed trichilemmomal changes without apparent follicular origin. Studies for common papilloma virus structural antigens were negative, apart from a typical common wart in one patient. Immunohistochemical studies in 6 facial trichilemmomas and acral keratoses, using a panel of anti-keratin antibodies, disclosed only abnormal differentiation with lack of large keratins in the lobulate trichilemmomas. Nine biopsies revealed a distinctive type of fibroma characterized by an organized pattern of interwoven fascicles of collagen bundles with a laminated or tortuous appearance, embedded in abundant mucin. A number of fibromas showed striking hyalinization; these may represent a second microscopic hallmark of Cowden's disease in addition to facial trichilemmomas.
对7例考登病患者的40份皮肤活检样本进行了组织学、组织化学和免疫组织化学研究。大多数面部活检样本显示了一系列外毛根鞘瘤及相关毛囊畸形，包括圆柱状外毛根鞘瘤、小叶状外毛根鞘瘤（14个病灶），以及一种与倒置性毛囊角化病有共同特征的角化型。一处面部肿物显示出外毛根鞘瘤样改变，但未发现明显的毛囊起源。除1例患者的典型寻常疣外，对常见乳头瘤病毒结构抗原的检测均为阴性。使用一组抗角蛋白抗体对6例面部外毛根鞘瘤和肢端角化病进行免疫组织化学研究，结果显示小叶状外毛根鞘瘤仅存在异常分化，缺乏大型角蛋白。9份活检样本显示出一种独特类型的纤维瘤，其特征为胶原束交织成束，呈有组织的排列模式，外观呈层状或扭曲状，包埋于丰富的黏蛋白中。一些纤维瘤显示出明显的玻璃样变性；除面部外毛根鞘瘤外，这些纤维瘤可能代表考登病的第二个微观特征。
