Khan Sabina, Abeer Inara, Husain Musharraf, Jetley Sujata
Department of Pathology, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
Department of Surgery, Hamdard Institute of Medical Sciences and Research, Jamia Hamdard, New Delhi, India.
J Cytol. 2023 Apr-Jun;40(2):88-94. doi: 10.4103/joc.joc_122_21. Epub 2023 May 22.
Pilomatrixoma (PMX) is a relatively uncommon benign cutaneous neoplasm arising from skin adnexa. It presents as a subcutaneous asymptomatic nodule mostly in the head and neck region and is frequently misdiagnosed by the clinicians. Although easily diagnosed on histopathology, the cytologic features of PMX are less distinctive, depending on the stage and evolution of disease and may mimic other benign or even malignant lesions.
To study the cyto-morphological features of this uncommon neoplasm and identify its potential diagnostic pitfalls on fine needle aspiration cytology (FNAC).
Archival records of histopathologically diagnosed Pilomatrixoma were analyzed during study period of 2.5 years. Clinical diagnosis, preoperative FNA characteristics, and histopathological details were studied in each case. Cytologic pitfalls resulting in misdiagnosis of PMX cases on FNAC were evaluated in discordant cases.
The series showed male preponderance, with head and neck being the commonest site. Out of 21 histopathologically proven cases of PMX, cytological correlation was available in 18 cases. A correct cytologic diagnosis of PMX/adnexal tumor was rendered in 13 cases. Erroneous diagnosis was given in 5 cases mainly because of the predominance of one component over the other or non-representative-aspirated material.
The present study highlights the importance of careful screening of FNAC smears keeping in mind the variability in the relevant cytologic features of PMX and creates awareness about the lesions that can mimic Pilomatrixoma resulting in diagnostic dilemma.
毛母质瘤（PMX）是一种相对罕见的起源于皮肤附属器的良性皮肤肿瘤。它表现为皮下无症状结节，多位于头颈部区域，常被临床医生误诊。尽管在组织病理学上易于诊断，但PMX的细胞学特征不太明显，这取决于疾病的阶段和演变，并且可能模仿其他良性甚至恶性病变。
研究这种罕见肿瘤的细胞形态学特征，并确定其在细针穿刺细胞学检查（FNAC）中的潜在诊断陷阱。
在2.5年的研究期间，分析了经组织病理学诊断为毛母质瘤的存档记录。研究了每个病例的临床诊断、术前FNA特征和组织病理学细节。在不一致的病例中评估了导致PMX病例在FNAC上误诊的细胞学陷阱。
该系列显示男性居多，头颈部是最常见的部位。在21例经组织病理学证实的PMX病例中，18例有细胞学相关性。13例病例做出了PMX/附属器肿瘤的正确细胞学诊断。5例给出了错误诊断，主要是因为一种成分比另一种成分占优势或抽吸材料不具代表性。
本研究强调了在细针穿刺涂片检查时要牢记PMX相关细胞学特征的变异性进行仔细筛查的重要性，并提高了对可模仿毛母质瘤导致诊断困境的病变的认识。
