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Trichoblastic Fibroma: A Series of 10 Cases With Report of a New Plaque Variant

Trichoblastic Fibroma: A Series of 10 Cases With Report of a New Plaque Variant Abstract Background: Trichoblastic fibroma is a benign trichogenic tumor that has both epithelial and mesenchymal components and exhibits partial to complete follicular induction. We studied 10 cases of trichoblastic fibroma and reviewed their clinical and histologic features. Observations: All 10 tumors were located on the face. Nine of 10 patients were women. The mean age at presentation was 63.8 years (range, 35 to 81 years). Two distinct subsets of trichoblastic fibroma were identified: the nodular variant and the plaque variant. The nodular variant is well circumscribed, while the plaque variant is poorly circumscribed, has significant subclinical extension, and may represent the low-grade malignant counterpart of the classic nodular trichoblastic fibroma. Histologically, both variants demonstrate mesenchymal induction with keratin cysts, papillary mesenchymal bodies, and an inductive fibroblastic stroma. Conclusions: Trichoblastic fibroma may be confused clinically and/or histologically with basal cell carcinoma. Identification of the mixed epithelial-mesenchymal components is helpful in tumor recognition. The plaque variant trichoblastic fibroma has not been previously reported. Familiarity with this variant is important because of the potential for infiltrative growth.(Arch Dermatol. 1995;131:198-201) References 1. Headington JT, French J. Primary neoplasms of the hair follicle . Arch Dermatol. 1962;86:90-101.Crossref 2. Headington JT. Differentiating neoplasms of the hair germ . J Clin Pathol. 1970; 23:464-471.Crossref 3. Headington JT. Tumors of the hair follicle . Am J Pathol. 1976;85:480-505. 4. Rosen LB. A review and proposed new classification of benign acquired neoplasms with hair follicle differentiation . Am J Dermatopathol. 1990;12:496-516.Crossref 5. Headington JT. Tumors of hair follicle differentiation . In: Farmer EK, Hood AF, eds. Pathology of the Skin . Norwalk, Conn: Appleton and Lange; 1990:596-614. 6. Czernobilisky B. Giant solitary trichoepithelioma . Arch Dermatol. 1971;105: 587-588.Crossref 7. Filko GB, Tuppa NH, Miranda D, Matos MP, deSilva AL. Giant solitary trichoepithelioma . Arch Dermatol. 1984;120:797-798.Crossref 8. Long SA, Hurt MA, Santa Cruz DJ. Immature trichoepithelioma . J Cutan Pathol. 1988;15:353-358.Crossref 9. Grouls V, Hey A. Trichoblastic fibroma (fibromatoid trichoepithelioma) . Pathol Res Pract. 1988;183:462-468.Crossref 10. Slater DN. Trichoblastic fibroma: hair germ tumors revisited . Histopathology . 1987;11:327-331.Crossref 11. Requena L, Renendo G, Sarasa J, Hasson A, DeCastro A. Trichoblastic fibroma . J Cutan Pathol. 1990;17:381-384.Crossref 12. Gilks CB, Clement PB, Woods WS. Trichoblastic fibroma . Am J Dermatopathol. 1989;11:397-402.Crossref 13. Brook JD, Fitzpatrick JE, Golitz LE. Papillary mesenchymal bodies: a histologic finding useful in differentiating trichoepitheliomas from basal cell carcinomas . J Am Acad Dermatol. 1989;21:523-528.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Dermatology American Medical Association

Trichoblastic Fibroma: A Series of 10 Cases With Report of a New Plaque Variant

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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-987X
eISSN
1538-3652
DOI
10.1001/archderm.1995.01690140082014
Publisher site
See Article on Publisher Site

Abstract

Abstract Background: Trichoblastic fibroma is a benign trichogenic tumor that has both epithelial and mesenchymal components and exhibits partial to complete follicular induction. We studied 10 cases of trichoblastic fibroma and reviewed their clinical and histologic features. Observations: All 10 tumors were located on the face. Nine of 10 patients were women. The mean age at presentation was 63.8 years (range, 35 to 81 years). Two distinct subsets of trichoblastic fibroma were identified: the nodular variant and the plaque variant. The nodular variant is well circumscribed, while the plaque variant is poorly circumscribed, has significant subclinical extension, and may represent the low-grade malignant counterpart of the classic nodular trichoblastic fibroma. Histologically, both variants demonstrate mesenchymal induction with keratin cysts, papillary mesenchymal bodies, and an inductive fibroblastic stroma. Conclusions: Trichoblastic fibroma may be confused clinically and/or histologically with basal cell carcinoma. Identification of the mixed epithelial-mesenchymal components is helpful in tumor recognition. The plaque variant trichoblastic fibroma has not been previously reported. Familiarity with this variant is important because of the potential for infiltrative growth.(Arch Dermatol. 1995;131:198-201) References 1. Headington JT, French J. Primary neoplasms of the hair follicle . Arch Dermatol. 1962;86:90-101.Crossref 2. Headington JT. Differentiating neoplasms of the hair germ . J Clin Pathol. 1970; 23:464-471.Crossref 3. Headington JT. Tumors of the hair follicle . Am J Pathol. 1976;85:480-505. 4. Rosen LB. A review and proposed new classification of benign acquired neoplasms with hair follicle differentiation . Am J Dermatopathol. 1990;12:496-516.Crossref 5. Headington JT. Tumors of hair follicle differentiation . In: Farmer EK, Hood AF, eds. Pathology of the Skin . Norwalk, Conn: Appleton and Lange; 1990:596-614. 6. Czernobilisky B. Giant solitary trichoepithelioma . Arch Dermatol. 1971;105: 587-588.Crossref 7. Filko GB, Tuppa NH, Miranda D, Matos MP, deSilva AL. Giant solitary trichoepithelioma . Arch Dermatol. 1984;120:797-798.Crossref 8. Long SA, Hurt MA, Santa Cruz DJ. Immature trichoepithelioma . J Cutan Pathol. 1988;15:353-358.Crossref 9. Grouls V, Hey A. Trichoblastic fibroma (fibromatoid trichoepithelioma) . Pathol Res Pract. 1988;183:462-468.Crossref 10. Slater DN. Trichoblastic fibroma: hair germ tumors revisited . Histopathology . 1987;11:327-331.Crossref 11. Requena L, Renendo G, Sarasa J, Hasson A, DeCastro A. Trichoblastic fibroma . J Cutan Pathol. 1990;17:381-384.Crossref 12. Gilks CB, Clement PB, Woods WS. Trichoblastic fibroma . Am J Dermatopathol. 1989;11:397-402.Crossref 13. Brook JD, Fitzpatrick JE, Golitz LE. Papillary mesenchymal bodies: a histologic finding useful in differentiating trichoepitheliomas from basal cell carcinomas . J Am Acad Dermatol. 1989;21:523-528.Crossref

Journal

Archives of DermatologyAmerican Medical Association

Published: Feb 1, 1995

References