Ch34cP26c Pilomatrixoma

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F1Ch34c: This small pilomaxtrix is circumscribed but not encapsulated. Islands and cords of ghost cells are entrapped in a fibrous matrix. In the bright red areas, the patterns of bone spicules are represented; rounded areas in some of the spicules resemble haversian canals that have been cut in cross section. The fractured lavender material to the left is a calcium deposit.


F2Ch34c: At higher magnification the more intensely acidophilic areas are simply aggregates of ghost cells that have acquired acidophilia. On the other hand, ghost cells tend to undergo calcification, and areas of dystrophic calcification serve as nidi that can undergo ossification. The pale acidophilic areas are also composed of ghost cells. Vascularized fibrous tissue has extended into the domain of the ghost cells. Histiocytes and giant cells at the interface between fibrous tissue and ghost cells have a role in the resorption of the ghost cells, and in the formation of lytic defects into which the fibrous tissue extends.


F3Ch34c: Histiocytes, and foreign body giant cells, at the periphery of the collections of ghost cells, have a role in the removal of the dead keratinized cells. The more brightly acidophilic areas have the tinctorial qualities of fibrinoid degeneration.


F4Ch34c: From right to left, the first population of epithelial cells has basaloid qualities; nuclear characteristics are uniform and the cells have scanty cytoplasm. The next layer is composed of pale, acidophilic squamoid cells. The next layer is brightly acidophilic; the cells have fine acidophilic granules in their cytoplasm, and pyknotic nuclei. To the far left, the keratinized debris is acidophilic; small, rounded defects mark the site in which a pyknotic nucleus has undergone lysis. Focally, near the left margin, the keratinized debris forms streamers.


F5Ch34c: Squamous cells form a whorl in this population of germinative cells. The green arrow identifies a small rounded structure that resembles a small hair shaft.


F6Ch34c: The pattern of the epithelial component resembles a distorted hair bulb. Centrally, the distinctive acidophilic cells form a column that streams upward and to the left. A population of pale, squamoid cells is represented to both sides of the column. The cells of the column have the qualities of a specific trichogenic component. By cytologic features, the cells of the column are of the same type as those that give rise to the hair shaft of an anagen follicle .


F7Ch34c: In this area, a population of variably pigmented cells form a plaque that has displaced the component of germinative cells. The cells have pale cytoplasm, and some have a dendritic quality. These cells are interpreted as melanocytes. The cytologic features might be compared to those of type A spindle cell “melanomas” of the eye.


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