Kaddu S, Soyer H P, Hödl S, Kerl H
Department of Dermatology, University of Graz, Austria.
Am J Dermatopathol. 1996 Aug;18(4):333-8. doi: 10.1097/00000372-199608000-00001.
In 1983, Ackerman proposed that pilomatricoma represents an infundibular-matrix cyst in its early stages. To study the evolution of this cystic neoplasm, we examined 118 lesions from 116 patients with pilomatricoma histopathologically and categorized the lesions into four distinct and chronological stages: early, fully developed, early regressive, and late regressive. Early lesions (eight cases) were small cystic structures lined by squamoid and basaloid epithelium containing keratin filaments and faulty hair matrix material composed of shadow cells. Fully developed lesions (27 cases) were large neoplasms lined by basaloid epithelium at their periphery, and within, composed of irregularly shaped, densely packed zones of cornified masses containing shadow cells. Early regressive lesions (37 cases) had no apparent epithelial lining but did have basaloid cell foci at the periphery; within, they were composed of pink hair matrix material with shadow cells surrounded by granulation tissue with inflammatory infiltrate and multinucleated histiocytic giant cells. Late regressive lesions (42 cases) had no epithelial component and were composed of irregularly shaped, partially confluent masses of faulty hair material, and calcified (and sometimes metaplastically ossified) shadow cells embedded in a desmoplastic stroma, with little or no inflammatory infiltrate. In four cases, there was a relatively large dermal nodule composed of several interconnected lobules that consisted largely of basaloid cells with only a few areas of shadow cells. We interpreted these lesions as proliferating pilomatricomas. Based upon our histopathologic findings, we propose that pilomatricomas may be categorized into four distinct morphological stages and that these stages reflect the "life" of a pilomatricoma. Thus, the lesion begins as an infundibular matrix cyst and ends up as a calcified and ossified nodule with no visible epithelial component.
1983年，阿克曼提出毛母质瘤在早期阶段表现为漏斗状-基质囊肿。为了研究这种囊性肿瘤的演变过程，我们对116例毛母质瘤患者的118个病变进行了组织病理学检查，并将这些病变分为四个不同的、按时间顺序排列的阶段：早期、完全发育期、早期消退期和晚期消退期。早期病变（8例）为小的囊性结构，内衬鳞状上皮和基底样上皮，含有角蛋白丝以及由影子细胞组成的发育不良的毛母质物质。完全发育的病变（27例）为大的肿瘤，其周边由基底样上皮衬里，内部由不规则形状、密集排列的角化团块区域组成，含有影子细胞。早期消退的病变（37例）没有明显的上皮衬里，但在周边有基底样细胞灶；内部由粉红色的毛母质物质和影子细胞组成，周围是伴有炎性浸润和多核组织细胞巨细胞的肉芽组织。晚期消退的病变（42例）没有上皮成分，由不规则形状、部分融合的发育不良毛质物质团块以及嵌入致密性间质中的钙化（有时化生骨化）影子细胞组成，几乎没有炎性浸润。在4例中，有一个相对较大的真皮结节，由几个相互连接的小叶组成，主要由基底样细胞构成，只有少数区域有影子细胞。我们将这些病变解释为增生性毛母质瘤。根据我们的组织病理学发现，我们提出毛母质瘤可分为四个不同的形态学阶段，这些阶段反映了毛母质瘤的“生命历程”。因此，病变始于漏斗状基质囊肿，最终成为一个没有可见上皮成分的钙化和骨化结节。
