Basaloid Follicular Hamartoma of the Eyelid
Basaloid Follicular Hamartoma of the Eyelid
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DOI：
10.1097/iop.0b013e3182467dfc
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发表时间：
2012-09-01
影响因子：
2
通讯作者：
Kim, Nancy
中科院分区：
文献类型：
--
作者：
Jakobiec, Frederick A.;Zakka, Fouad R.;Kim, Nancy
86岁女性左下眼睑慢慢出现一个孤立的0.3 x 0.2 cm丘疹。完全切除发现蜂窝状病变，由交错的基底细胞链组成，不附着于表皮，而是从扩张的毛囊延伸到真皮层。诊断为单发基底样卵泡错构瘤，也可发生于多发性、全身性和遗传性形式，有时伴有全身性疾病。病变表现出独特的cd34阳性，轻度细胞黏液样基质，基底细胞链内散布着许多ck20阳性的Merkel细胞，仅在基质的最外层细胞内表现出BCL-2阳性。这些免疫组织化学特征与基底细胞癌相反，基底细胞癌需要更积极的手术治疗。除基底细胞癌外，基底细胞样滤泡错构瘤的鉴别诊断还包括纤维滤泡瘤、滤泡腺瘤、多孔瘤和小梁（默克尔细胞）癌。
An 86-year-old woman slowly developed a solitary 0.3 x 0.2-cm papule on the left lower eyelid. Complete excision disclosed a honeycombed lesion composed of interlacing basaloid strands unattached to the epidermis but rather extending into the dermis from a dilated hair follicle. The diagnosis was a solitary basaloid follicular hamartoma that can also occur in multiple, generalized, and inherited forms, sometimes with an associated systemic disease. The lesion exhibited a distinctive CD34-positive, mildly cellular myxoid stroma with many CK20-positive Merkel cells scattered within the basaloid cellular strands, which exhibited BCL-2 positivity only within the outermost cells bordering the stroma. These immunohistochemical features are the opposite of those displayed by basal cell carcinomas, which require more aggressive surgical management. Besides basal cell carcinomas, the differential diagnosis of basaloid follicular hamartoma includes fibrofolliculoma, tumor of the follicular infundibulum, poroma, and trabecular (Merkel cell) carcinoma.