Is Tumor of Follicular Infundibulum a Reaction to Dermal Scarring?

Tumor of follicular infundibulum (TFI) is currently believed to be a benign epithelial neoplasm with follicular differentiation. It has been suggested that TFI is associated with dermal scarring, but further investigation is needed to confirm this correlation. To approach this question, a retrospective study was presented, a total of 67 cases (64 lesions) were found in a search covering cases over a 10-year period. Overall, the presence of histological dermal scarring was noted in 34 of 64 (53.13%) cases. Of the cases where TFI was an incidental finding, the presence of dermal scarring was noted in 13 of 18 (72.22%) cases. Meanwhile, of the cases where TFI was the main diagnosis, the presence of dermal scarring was noted in 12 of 34 (35.29%) cases. This suggests that TFI may, in some cases, represent an epidermal reaction pattern to dermal scarring.

Subcutaneous sarcoidosis without systemic involvement.

Subcutaneous sarcoidosis is a rare variant of cutaneous sarcoidosis, which typically presents as single or multiple, indurated, ill-defined plaques, typically on the upper extremities. Granulomas consisting of macrophages with multinucleated giant cells and sparse lymphocytic inflammation are confined to the subcutaneous tissue, rather than to their usual location within the dermis in typical lesions of cutaneous sarcoidosis. An association between subcutaneous sarcoidosis and systemic involvement has been reported, although response to treatment and prognosis remain good. We report a case of a middle-aged woman with subcutaneous sarcoidosis, with negative work-up for systemic involvement of sarcoidosis. Interestingly, family history was significant for a son who died from complications of pulmonary sarcoidosis. The patient was successfully treated with a tapering course of oral prednisone in combination with hydroxychloroquine.

Morphological diversity of trichodiscomas and fibrofolliculomas.

Trichodiscomas (TDs) and fibrofolliculomas (FFs) are hamartomatous tumors, which are usually small facial papules; they are frequently a disease marker for Birt-Hogg-Dubé syndrome, their recognition is important because of this association. Some believe that TD and FF is the same lesion, others have proposed the term "mantleoma" to include the morphological continuum of both of these lesions. Recently, some variants (eg, spindle cell TD, TD with lipomatous metaplasia) have been described. The authors attempt to describe a review of cases with combined features of TF and FF, as well as the recently described variants, and variants not previously described to our knowledge (myxoid/mucin predominant, pseudocartilaginous, sclerotic/fibrotic, prominent apocrine/eccrine, leiomyoma-like, with vascular proliferation). It has been hypothesized that the hair bulge stem cells may be responsible for the broad spectrum of histological variation in these tumors.

Poorly differentiated carcinoma arising in the setting of erythema ab igne.

Erythema ab igne (EAI) is a reticulated, erythematous, or hyperpigmented dermatosis that is caused by chronic exposure to infrared radiation. Chronic lesions of EAI have significant potential for malignant transformation. We report a case of poorly differentiated carcinoma arising within a patch of long-standing EAI on the lower extremity of a 92-year-old female. This case highlights the importance of recognizing EAI early and counseling patients to avoid further exposure to the offending infrared source to reduce the risk of malignant transformation. EAI has been associated with several different types of cutaneous neoplasms including the Merkel cell carcinoma, squamous cell carcinoma, and cutaneous marginal zone lymphoma.

Epidermolytic hyperkeratosis and congenital platelike osteoma cutis in a child.

Epidermolytic hyperkeratosis is a rare congenital ichthyosis. Platelike osteoma cutis also is a rare diagnosis and is associated with abnormal ossification of cutaneous or subcutaneous tissue. A 17-month-old Hispanic girl presented with a plate of subcutaneous bone since birth as well as considerable scaling and hyperkeratosis centered around the joints. Histologic examination confirmed the diagnosis of both epidermolytic hyperkeratosis and osteoma cutis. Although there have been some cases of epidermolytic hyperkeratosis with other dermatologic conditions, we report a rare case of epidermolytic hyperkeratosis and platelike osteoma cutis.

Fine needle aspiration findings in malignant ameloblastoma: a case report and differential diagnosis.

We present a case of malignant ameloblastoma presenting in the posterior mandible and cervical lymph nodes of an African American child. This case is somewhat unusual in that the patient was an adolescent and presented with metastatic disease. This partly clinical as well as cytologic diagnosis was facilitated by the presence of typical ameloblastoma cytology in multiple cervical lymph nodes adjacent to the histologically confirmed intraosseous ameloblastoma. Although cytology is helpful in diagnosing ameloblastoma, its features are by no means definitive as there are several cytologic mimics. A high index of suspicion is therefore necessary to confirm or exclude ameloblastoma when evaluating any jaw lesion and/or adjacent enlarged lymph nodes by cytologic examination. Adequate sampling is paramount to accurate diagnosis, and is especially important when attempting to distinguish ameloblastoma from ameloblastic carcinoma.

Imprint cytology of high-grade immature ovarian teratoma: a case report, literature review, and distinction from other ovarian small round cell tumors.

Immature ovarian teratoma (IOT) is a rare and aggressive malignant neoplasm characterized by immature neural tissue. The cytomorphologic features have only rarely been described. We herein describe an additional case and review the literature regarding this entity. To the best of our knowledge, this is the first reported case with imprint cytology. A 35-year-old woman presented with a pelvic mass which was resected and sent for frozen section evaluation. Imprint smears and frozen section of the mass were diagnostic of IOT. IOT has diagnostic cytologic features which show complete concordance with histology. Differential diagnoses include other small round cell neoplasms such as ovarian neuroblastoma, small cell carcinoma of hypercalcemic type, primitive neuroectodermal tumor, Wilm's tumor, desmoplastic small round cell tumor, and Non-Hodgkin lymphoma. Distinguishing IOT from these tumors can be challenging however if diligent morphologic study and/or ancillary studies are performed accurate diagnosis is possible.