Ch32P24-L3 Tricholemmoma-like
Mixed Tumor

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F1Ch32 (J5018): This is a classic pattern of the clear cell component of a tricholemmoma of “anagen” type. The cytoplasm of most cells is optically clear; cell membranes are thin. There is mild nuclear atypia. Near the upper right corner, basal cells form palisades about an island of stroma.

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F2Ch32 (5018): A microcyst in the clear cell component contains mucinous material.

Fig.J5018trichlemmom050

F3Ch32 (J5018): Tumor cells form fascicles near the top of the field; some of the cells are individually isolated in a watery or hyalinized matrix. In the fascicles, the cells have pale acidophilic cytoplasm; they are outlined by brightly acidophilic fibers.

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FCh(J5018): Some of the tumor cells form fascicles; some are individually isolated in a hyalinized matrix. The combination of features could be accepted as an expression of spindle cell transformation in which a hyalinized matrix has been induced; as such, the lesion might be classified as a variant of a follicular mixed tumor.

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FCh(J5018): In the fascicles, brightly acidophilic fibers outline the tumor cells. The relationships might be interpreted, on H&E stained sections, as evidence that the fibers have basement membrane qualities. The possibilities that either the fibers are of a myoepithelial nature, or are evidence of trichogenic keratinization must also be considered.

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FCh(J5018): Tumor cells are spindle-shaped; some are individually isolated in a hyaline matrix.

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