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Dermpath-India Pathology of Trichoblastoma
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As originally described by Headington these are very rare tumours that tend to be larger and more deeply located than trichoepithelioma. They are formed of varying combinations of basaloid germ cells and follicular mesenchyme with varying degrees of primitive hair bulb formation (stromal induction). Trichoblastomas are not aggressive unless they contain an element of basal cell carcinoma. Clinical presentation: Presents as a well circumscribed, solitary lesion (more than 1 cm in diameter). Site: Head, particularly the scalp is a common site.
Variants: - Clear cell ; - Pigmented ; - Adamantinoid ; - Rippled-pattern; Rippled-pattern trichoblastoma is characterized by peculiar arrangement of the basaloid cells in linear rows parallel to one another similar to the palisading of nuclei of Verocay bodies seen in schwannomas. No sebaceous differentiation. Differential diagnosis: Rippled-pattern sebaceoma. - Cutaneous lymphadenoma is an adamantinoid variant of trichoblastoma. Depending on the degree of differentiation toward other follicular components and the relative prominence of stromal and epithelial elements this group was classically subdivided into trichoblastoma nos, trichoblastic fibroma and trichogenic trichoblastoma. - Trichoblastic fibroma include both germ and fibrous stroma. - Trichogenic trichoblastoma is the most mature form and include complete hair follicle. - Cystic trichoblastoma - Cystic trichoblastoma (so-called trichoblastic infundibular cyst): a report of three new cases.
Basal cell carcinoma; Classic trichoepithelioma (more keratocysts are present and distinction is very difficult). Trichoblastic carcinoma (or malignant trichoblastoma) is a rare malignant cancer of adnexal structures with morphological features that in some cases are reminiscent of a trichoblastoma.
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