Ch33P25-L3 Tricholemmal CA
(small & low grade)

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F1Ch33 (J4320): This is a broad flat lesion. In areas, the lesion extends into the dermis to about the level of the sweat glands. Although each column appears to be circumscribed, the tumor has “pushed” into the reticular dermis. In combination with features of cytologic atypia and mitotic activity, the lesion is interpreted as a carcinoma.

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F2Ch33 (J4320): In areas at the advancing margin, elongated, thin columns of tumor cells extend in asymmetrical patterns beyond the confines of the primary columns. Nuclear atypia is evident at this magnification. In the column to the right and above, many of the cells have clear cytoplasm.

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F3Ch33 (J4320): Green arrows identify foci of microinvasion of the stroma. The isolated nest near the top of the field is partly outlined by a basement membrane.

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F4Ch33 (J4320): Nuclei show hyperchromatism, variation in size, mild pleomorphism, and variations in polarity. The loosely laminated stroma at the advancing margin has the qualities of a tumor stroma (as seen in invasive tumors).

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F5Ch33 (J4320): Nuclei vary in size, outline, and orientation. Nucleoli are prominent. There are occasional dyskeratotic cells. Nuclear atypia is moderately atypical. Some of the cells have vacuolated cytoplasm.

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F6Ch33 (J4320): Nuclei vary in size, outline, and orientation. There is mild pleomorphism.

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F7Ch33 (J4320); There are occasional mitotic figures. The basement membrane is thin; often, the basement membrane of classic tricholemmomas is wide and hyalinized. To the right, at the bottom of the field, clear cells are prominent.

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F8Ch33 (J4320): In this papilla-like component of stroma, the matrix is mucinous.

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