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Bernard Cribier - One of the best experts on this subject based on the ideXlab platform.
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PHLDA1, a follicular stem cell marker, differentiates clear-cell/granular-cell Trichoblastoma and clear-cell/granular cell basal cell carcinoma: a case-control study, with first description of granular-cell Trichoblastoma.
The American Journal of dermatopathology, 2014Co-Authors: Maxime Battistella, Bernard Peltre, Bernard CribierAbstract:BACKGROUND Granular-cell or clear-cell basal cell carcinomas (BCCs), and clear-cell Trichoblastomas have rarely been reported in the literature. PHLDA1 is a follicular stem cell marker, the expression of which has been reported to differentiate trichoepithelioma from BCCs. We wondered whether (1) granular-cell Trichoblastoma exists and (2) PHLDA1 expression can differentiate a clear- and/or granular-cell Trichoblastoma and a BCC. METHODS In the records of 2 pathology departments, 12 clear- and/or granular-cell Trichoblastomas and BCCs were found. Epidemiological, histopathological, and immunohistochemical data for PHLDA1, Ki67, and AE1-AE3; and cytokeratins 17, 19, 20, and 6hf were collected. RESULTS Trichoblastomas and clear- and/or granular-cell BCCs occurred in 7 patients (36-62 years; mean: 49) and in 5 patients (63-91 years; mean: 77), respectively. Three granular-cell Trichoblastomas were identified. Both granular and clear-cell changes were present in 4 BCCs. The patterns of expression for AE1/AE3, CK17, CK19, CK6hf, and CK20 were not helpful in differentiating Trichoblastoma from BCC. PHLDA1 expression was diffusely or partially present in all Trichoblastomas (5/5) and absent in BCCs (0/4) (P = 0.008). CONCLUSIONS Granular- and/or clear-cell changes are rare findings in Trichoblastoma and BCC. First, we show that granular-cell Trichoblastomas do occur. Second, PHLDA1 expression is a useful addition in differentiating Trichoblastoma and BCC.
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Basaloid tumors in nevus sebaceus revisited: the follicular stem cell marker PHLDA1 (TDAG51) indicates that most are basal cell carcinomas and not Trichoblastomas
Journal of cutaneous pathology, 2013Co-Authors: Klaus Sellheyer, Heinz Kutzner, Bernard Cribier, Paula Nelson, Arno RuttenAbstract:Background Until the 1990s, basal cell carcinoma (BCC) was viewed as the most common epithelial neoplasm developing in association with nevus sebaceus (NS). Currently, Trichoblastoma is thought of as the most prevalent basaloid neoplasm in NS. The follicular stem cell marker pleckstrin homology-like domain, family A, member 1 (PHLDA1) also known as T-cell death-associated gene 51 (TDAG51) labels trichoepithelioma (TE) but not BCC. Therefore, we explored its usefulness in basaloid neoplasms developing in NS. Methods We studied immunohistochemically PHLDA1 in 10 nodular BCCs, 11 TEs, 11 Trichoblastomas and 25 NS with basaloid tumors. Additionally, we examined the expression of BCC marker BerEP4 and the distribution of Merkel cells that function as surrogate markers for benign follicular neoplasms. Results Nineteen of the 25 basaloid tumors in NS were PHLDA1-negative comparable to BCC arising de novo and six tumors were PHLDA1-positive comparable to solitary Trichoblastomas and TEs. Fewer Merkel cells were seen in BCCs associated with NS when compared with Trichoblastoma. BerEP4 did not discriminate between the neoplasms. Conclusions We raise concern that the unquestioned assessment that basaloid tumors developing in association with NS represent mostly Trichoblastomas and not BCC may not be true. This influences clinical care, as it is paramount in the decision of whether to excise these lesions or not.
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Primary Cutaneous Neuroendocrine Carcinoma Within a Cystic Trichoblastoma: A Nonfortuitous Association?
The American Journal of dermatopathology, 2011Co-Authors: Maxime Battistella, Bernard Peltre, Luc Durand, Thomas Jouary, Bernard CribierAbstract:Merkel cell (primary cutaneous neuroendocrine) carcinoma is a rare neoplasm of the skin. Its occurrence has been reported in association with other cutaneous neoplasms (Bowen disease, squamous cell carcinoma) in cases regarded as collision tumors. It has recently been described in association with cysts of the follicle apparatus. We present a unique case of rapidly growing nodular tumor on the left forearm of an 84-year-old woman, which proved to be a Merkel cell carcinoma located within a cystic Trichoblastoma. The malignant component located in the center of the lesion had typical histopathological and immunohistochemical features of Merkel cell carcinoma. It was surrounded by an epithelial proliferation, made of K17-positive basaloid cells, whose aspects where those of Trichoblastoma in a retiform pattern. Both lesions were intertwined, suggesting that the Merkel cell carcinoma had developed within a previously existing Trichoblastoma and that it derived from the follicular Merkel cells present in the Trichoblastoma. The unique features of this case, together with the reported cases of Merkel cell carcinoma arising within follicular lesions, and the fact that numerous Merkel cells are normally localized in the adult hair follicle, further support the hypothesis of a histogenetic link between normal follicular Merkel cells and Merkel cell carcinoma.
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tumors arising in nevus sebaceus a study of 596 cases
Journal of The American Academy of Dermatology, 2000Co-Authors: Bernard Cribier, Y Scrivener, E GrosshansAbstract:Abstract Background: Prophylactic surgical excision of nevus sebaceus (NS) during childhood is often recommended because various neoplasms can occur on NS. The proportion of malignant tumors occurring on NS is highly variable among the published series, and there are controversies on the nature of these neoplasms because many of the previously described basal cell carcinomas could actually be Trichoblastomas, which are benign follicular tumors. Objective: We retrospectively analyzed all cases of NS of our collection, excised during the period from 1932 through 1998, and recorded all associated epithelial and nonepithelial changes. We especially differentiated basal cell carcinomas from Trichoblastomas by silhouette analysis and examination of the stroma. These findings were analyzed according to gender, age, and localization. Methods: Microscopic analysis of NS by two examiners was performed independently of clinical data. Results: A total of 596 cases were included from 290 females and 306 males, mean age 25.4 years (range, 1 month to 87 years); 232 were excised in children younger than 16 years. NSs were located on the scalp in 49.8% of cases. Basal cell carcinomas were found in 5 cases (0.8%, mean age 39.3 years) and benign tumors in 81 cases (13.6%, mean age 46.3 years). Syringocystadenoma papilliferum (n = 30, 15 males, 15 females) and Trichoblastoma (n = 28, 7 males, 21 females) were the most frequent benign tumors. NS with associated tumors were located on the scalp in 79% of cases. Only 4 benign tumors (1.7%) and 2 warts were observed in patients younger than 16 years. Various types of epithelial hyperplasia were noted that could not be considered neoplasms, as well as epidermal and apocrine cysts. Conclusion: The rate of malignant tumors arising on NS was very low and we did not observe such cases in children, who had associated benign tumors in only 1.7% of cases. Benign neoplasms were common and most of them occurred on the scalp; this was not a bias resulting from a longer duration before surgery. Trichoblastoma and not basal cell carcinoma was the most frequent follicular tumor associated with NS and showed a striking female predominance. Most Trichoblastomas had previously been misdiagnosed but could actually be easily recognized by typical histologic features. Because most tumors occurred in adults older than 40 years, our study suggests that prophylactic surgery in young children is of uncertain benefit. Clinical follow-up is probably sufficient, and even those cases with clinical changes often proved to be benign tumors or warts. (J Am Acad Dermatol 2000;42:263-8.)
Yutaka Narisawa - One of the best experts on this subject based on the ideXlab platform.
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Cystic Trichoblastoma: a report of two cases with an immunohistochemical study.
The Journal of dermatology, 2015Co-Authors: Noriyuki Misago, Takuya Inoue, Yutaka NarisawaAbstract:We herein report two cases of cystic Trichoblastoma with an immunohistochemical study. The histopathological findings in these cases included new information, namely, their being composed of two and three cysts, the cystic components had features of a steatocystoma and a hybrid cyst in one case, and there were projections of an aggregation of Trichoblastoma, as well as papillary projections of follicular germinative cells, from the cyst walls. The follicular germinative cells observed in the papillary projections and in the aggregations of Trichoblastoma expressed cytokeratin-15 (clone C8/144B) and PHLDA1, markers of follicular stem cells. Cystic Trichoblastoma is a unique type of Trichoblastoma, which originates from the cyst walls of an infundibular cyst (usually) or steatocystoma/hybrid cyst (rarely). In some cases, a trichoblastic infundibular cyst is considered to be a minor form (or possibly a primitive stage) of cystic Trichoblastoma.
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Nestin expression in stromal cells of Trichoblastoma and basal cell carcinoma
Journal of The European Academy of Dermatology and Venereology, 2010Co-Authors: Noriyuki Misago, Toru Mori, Yutaka NarisawaAbstract:Background Both Trichoblastoma and basal cell carcinoma (BCC) are considered to be a benign and malignant neoplasm of follicular germinative cells respectively. A recent investigation revealed that the mesenchymal cells in the perifollicular sheath and evolving follicular papilla of embryonic hair germs and those cells in hair follicles in early anagen express nestin. Objective The aim of the present study was to investigate whether Trichoblastoma and BCC recapitulate the epithelial–mesenchymal interactions in embryonic hair germs or early anagen hair follicles by expressing nestin in stromal cells. Methods Immunohistochemical staining was performed with antibody against nestin for 15 Trichoblastomas including large/small nodular, retiform and trichoepithelioma types, while adding the superficial type associated with nevus sebaceous and for 20 BCCs including superficial, nodular, nodulo-infiltrative, and infiltrative/micronodular types. Results In all 15 Trichoblastomas, the stromal cells expressed nestin with variable positive reactions, except for superficial Trichoblastomas within nevus sebaceous lesions, in which stromal cells were constantly positive for nestin. In all 20 BCCs, the stromal cells were basically negative for nestin. Conclusions The development of Trichoblastomas incompletely recapitulates the epithelial–mesenchymal interactions in embryonic hair germs or early anagen hair follicles, whereas BCCs fundamentally have lost this ability. Among the various types of Trichoblastomas, the superficial type associated with nevus sebaceous was found to have the most similar character to either embryonic hair germs or early anagen hair follicles.
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Merkel cell-poor Trichoblastoma with basal cell carcinoma-like foci.
The American Journal of dermatopathology, 2007Co-Authors: Noriyuki Misago, Toshimi Satoh, Yoshihiro Miura, Kohtarou Nagase, Yutaka NarisawaAbstract:We reexamined 11 cases of Trichoblastoma, and two cases of Trichoblastoma with basal cell carcinoma (BCC)-like foci were found. In these two Trichoblastomas with BCC-like foci, the BCC-like foci were often localized in peripheral or deep areas of lesions extending out of the fibrocytic stroma. Immunohistochemistry was performed in five conventional Trichoblastomas and in two Trichoblastomas with BCC-like foci, using antibodies against CK20 and CK15. No CK20-positive Merkel cells and no expression of CK15 were seen in any neoplastic aggregations of the two Trichoblastomas with BCC-like foci. In contrast, increased numbers of Merkel cells and positive staining for CK15 were observed in all five Trichoblastomas without BCC-like foci. The five Trichoblastomas without BCC-like foci included two Trichoblastomas with a popped out or shelled out appearance, which characteristically had a thick fibrous capsule surrounding the fibrotic stroma, demonstrating numerous Merkel cells in the aggregations. Some Trichoblastomas may undergo mutations, resulting in the development of foci of BCC and in the loss of the expression of CK15 as well as the disappearance of Merkel cells.
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sebaceous carcinoma Trichoblastoma and sebaceoma with features of Trichoblastoma in nevus sebaceus
American Journal of Dermatopathology, 2001Co-Authors: Noriyuki Misago, Hanako Kodera, Yutaka NarisawaAbstract:A 73-year-old woman had a linear yellowish plaque on the upper part of her right ear since birth. She presented because of the sudden growth of a nodule within the plaque. The plaque was waxy and yellowish, arching around the upper part of the ear. A reddish to yellowish large nodule was seen within the central part of the arc-shaped plaque; in addition, a small pigmented nodule, a small skin-colored nodule, and a few pigmented papules were observed in the anterior half of the arched plaque. Histopathologic examination revealed the large nodule to be sebaceous carcinoma, the small pigmented nodule to be Trichoblastoma, the small skin-colored nodule to be sebaceoma with the features of Trichoblastoma, a few pigmented papules to be superficial Trichoblastomas due to primitive follicular induction, and the linear yellowish plaque to be nevus sebaceus. Although our literature search revealed scanty reports of definite cases of sebaceous carcinoma in nevus sebaceus, the presented case demonstrated the occurrence of sebaceous carcinoma in nevus sebaceus. Malignant neoplasms occurring in nevus sebaceous seem to be extremely rare, but care should be taken when a large nodule suddenly grows in a lesion of nevus sebaceus, especially in older adults. The presented case also suggested a close relation between Trichoblastoma and sebaceoma. The cytokeratin staining pattern could not distinguish between sebaceous and follicular neoplasms in our case.
Han Seong Kim - One of the best experts on this subject based on the ideXlab platform.
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trichoblastic carcinoma arising from a nevus sebaceous
Archives of Plastic Surgery, 2016Co-Authors: Jin Tae Kim, Soo Hyang Lee, Pil Dong Cho, Hyun Woo Shin, Han Seong KimAbstract:Nevus sebaceous is a hamartoma of the cutaneous structures that often presents at birth and typically involves the face and scalp. Nevus sebaceous is frequently complicated by the development of a variety of other benign or malignant neoplasms. The most frequently reported benign neoplasms are Trichoblastoma and syringocystadenoma papilliferum. Malignant tumors are much less frequently observed in association with nevus sebaceous and include basal cell carcinoma, squamous cell carcinoma, sebaceous carcinoma, and others [1]. However, no previous reports have described trichoblastic carcinoma occurring secondarily to nevus sebaceous. We report a case of malignant Trichoblastoma that arose from nevus sebaceous of the scalp in a 38-year-old woman.
Noriyuki Misago - One of the best experts on this subject based on the ideXlab platform.
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Cystic Trichoblastoma: a report of two cases with an immunohistochemical study.
The Journal of dermatology, 2015Co-Authors: Noriyuki Misago, Takuya Inoue, Yutaka NarisawaAbstract:We herein report two cases of cystic Trichoblastoma with an immunohistochemical study. The histopathological findings in these cases included new information, namely, their being composed of two and three cysts, the cystic components had features of a steatocystoma and a hybrid cyst in one case, and there were projections of an aggregation of Trichoblastoma, as well as papillary projections of follicular germinative cells, from the cyst walls. The follicular germinative cells observed in the papillary projections and in the aggregations of Trichoblastoma expressed cytokeratin-15 (clone C8/144B) and PHLDA1, markers of follicular stem cells. Cystic Trichoblastoma is a unique type of Trichoblastoma, which originates from the cyst walls of an infundibular cyst (usually) or steatocystoma/hybrid cyst (rarely). In some cases, a trichoblastic infundibular cyst is considered to be a minor form (or possibly a primitive stage) of cystic Trichoblastoma.
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Nestin expression in stromal cells of Trichoblastoma and basal cell carcinoma
Journal of The European Academy of Dermatology and Venereology, 2010Co-Authors: Noriyuki Misago, Toru Mori, Yutaka NarisawaAbstract:Background Both Trichoblastoma and basal cell carcinoma (BCC) are considered to be a benign and malignant neoplasm of follicular germinative cells respectively. A recent investigation revealed that the mesenchymal cells in the perifollicular sheath and evolving follicular papilla of embryonic hair germs and those cells in hair follicles in early anagen express nestin. Objective The aim of the present study was to investigate whether Trichoblastoma and BCC recapitulate the epithelial–mesenchymal interactions in embryonic hair germs or early anagen hair follicles by expressing nestin in stromal cells. Methods Immunohistochemical staining was performed with antibody against nestin for 15 Trichoblastomas including large/small nodular, retiform and trichoepithelioma types, while adding the superficial type associated with nevus sebaceous and for 20 BCCs including superficial, nodular, nodulo-infiltrative, and infiltrative/micronodular types. Results In all 15 Trichoblastomas, the stromal cells expressed nestin with variable positive reactions, except for superficial Trichoblastomas within nevus sebaceous lesions, in which stromal cells were constantly positive for nestin. In all 20 BCCs, the stromal cells were basically negative for nestin. Conclusions The development of Trichoblastomas incompletely recapitulates the epithelial–mesenchymal interactions in embryonic hair germs or early anagen hair follicles, whereas BCCs fundamentally have lost this ability. Among the various types of Trichoblastomas, the superficial type associated with nevus sebaceous was found to have the most similar character to either embryonic hair germs or early anagen hair follicles.
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Merkel cell-poor Trichoblastoma with basal cell carcinoma-like foci.
The American Journal of dermatopathology, 2007Co-Authors: Noriyuki Misago, Toshimi Satoh, Yoshihiro Miura, Kohtarou Nagase, Yutaka NarisawaAbstract:We reexamined 11 cases of Trichoblastoma, and two cases of Trichoblastoma with basal cell carcinoma (BCC)-like foci were found. In these two Trichoblastomas with BCC-like foci, the BCC-like foci were often localized in peripheral or deep areas of lesions extending out of the fibrocytic stroma. Immunohistochemistry was performed in five conventional Trichoblastomas and in two Trichoblastomas with BCC-like foci, using antibodies against CK20 and CK15. No CK20-positive Merkel cells and no expression of CK15 were seen in any neoplastic aggregations of the two Trichoblastomas with BCC-like foci. In contrast, increased numbers of Merkel cells and positive staining for CK15 were observed in all five Trichoblastomas without BCC-like foci. The five Trichoblastomas without BCC-like foci included two Trichoblastomas with a popped out or shelled out appearance, which characteristically had a thick fibrous capsule surrounding the fibrotic stroma, demonstrating numerous Merkel cells in the aggregations. Some Trichoblastomas may undergo mutations, resulting in the development of foci of BCC and in the loss of the expression of CK15 as well as the disappearance of Merkel cells.
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sebaceous carcinoma Trichoblastoma and sebaceoma with features of Trichoblastoma in nevus sebaceus
American Journal of Dermatopathology, 2001Co-Authors: Noriyuki Misago, Hanako Kodera, Yutaka NarisawaAbstract:A 73-year-old woman had a linear yellowish plaque on the upper part of her right ear since birth. She presented because of the sudden growth of a nodule within the plaque. The plaque was waxy and yellowish, arching around the upper part of the ear. A reddish to yellowish large nodule was seen within the central part of the arc-shaped plaque; in addition, a small pigmented nodule, a small skin-colored nodule, and a few pigmented papules were observed in the anterior half of the arched plaque. Histopathologic examination revealed the large nodule to be sebaceous carcinoma, the small pigmented nodule to be Trichoblastoma, the small skin-colored nodule to be sebaceoma with the features of Trichoblastoma, a few pigmented papules to be superficial Trichoblastomas due to primitive follicular induction, and the linear yellowish plaque to be nevus sebaceus. Although our literature search revealed scanty reports of definite cases of sebaceous carcinoma in nevus sebaceus, the presented case demonstrated the occurrence of sebaceous carcinoma in nevus sebaceus. Malignant neoplasms occurring in nevus sebaceous seem to be extremely rare, but care should be taken when a large nodule suddenly grows in a lesion of nevus sebaceus, especially in older adults. The presented case also suggested a close relation between Trichoblastoma and sebaceoma. The cytokeratin staining pattern could not distinguish between sebaceous and follicular neoplasms in our case.
Jin Tae Kim - One of the best experts on this subject based on the ideXlab platform.
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trichoblastic carcinoma arising from a nevus sebaceous
Archives of Plastic Surgery, 2016Co-Authors: Jin Tae Kim, Soo Hyang Lee, Pil Dong Cho, Hyun Woo Shin, Han Seong KimAbstract:Nevus sebaceous is a hamartoma of the cutaneous structures that often presents at birth and typically involves the face and scalp. Nevus sebaceous is frequently complicated by the development of a variety of other benign or malignant neoplasms. The most frequently reported benign neoplasms are Trichoblastoma and syringocystadenoma papilliferum. Malignant tumors are much less frequently observed in association with nevus sebaceous and include basal cell carcinoma, squamous cell carcinoma, sebaceous carcinoma, and others [1]. However, no previous reports have described trichoblastic carcinoma occurring secondarily to nevus sebaceous. We report a case of malignant Trichoblastoma that arose from nevus sebaceous of the scalp in a 38-year-old woman.
