Votruba M, Collins C M, Harrad R A
Bristol Eye Hospital UK.
Eye (Lond). 1998;12 ( Pt 1):43-6. doi: 10.1038/eye.1998.7.
Currently, all lesions diagnosed clinically as basal cell carcinoma (BCC) are treated by the excision of the lesion with 3-4 mm margins followed by histopathological examination to assess clearance and confirm the diagnosis. We present the findings of surgical incisional and excisional biopsy of three young patients diagnosed on clinical examination as having BCC, who were found on histological examination to have trichoepithelioma. Whilst it may be possible to distinguish the features of trichoepithelioma in incisional biopsy specimens on morphological grounds alone it is often difficult, and immunohistochemical staining, to delineate the features of the basement membrane, provides useful additional information in the histological diagnosis. As trichoepithelioma is more common in the young it should be considered in the differential diagnosis in young patients presenting with BCC-like lesions of the periocular tissues. This subgroup of patients should have incisional biopsy carried out, and if the diagnosis of trichoepithelioma is confirmed the lesion may be excised with a small margin of healthy tissue, thereby facilitating surgical repair.
目前，所有临床诊断为基底细胞癌（BCC）的病变均通过切除病变组织并保留3 - 4毫米切缘，随后进行组织病理学检查以评估切缘是否干净并确认诊断。我们展示了三名年轻患者的手术切开活检和切除活检结果，这三名患者临床检查诊断为BCC，但组织学检查发现为毛发上皮瘤。虽然仅基于形态学依据有可能在切开活检标本中区分毛发上皮瘤的特征，但这通常很困难，而免疫组织化学染色用于描绘基底膜的特征，在组织学诊断中提供了有用的额外信息。由于毛发上皮瘤在年轻人中更常见，对于出现眼周组织类似BCC病变的年轻患者，在鉴别诊断时应考虑到这一疾病。这一亚组患者应进行切开活检，如果毛发上皮瘤的诊断得到证实，病变可在切除时保留一小圈健康组织边缘，从而便于手术修复。
