Excision biopsy from a raised lesion in the ear lobe 44/M



Shows skin with thin epidermis and dermis. Dermis shows multiple tiny spaces filled keratin, horny material and fragments of hair lined by squamous epithelium representing the hair follicles or horn cysts. Radiating from the wall of these primary hair follicles numerous well differentiated secondary hair follicles are present with outer and inner root sheath, trichohyaline granules and fine hair in centre. Stroma is cellular with fibroblasts. Chronic inflammation and melanin incontinence seen in superficial dermis. Few areas show islands of cells with basaloid nuclei and peripheral palisading. S/O: Benign tumor of epidermal appendages with differentiation towards hair structures, probably -trichifolliculoma - of ear lobe D/D: Trichoepithelioma

Mam the presence of myxoid stroma around the basaloid cells , nuclear typia and ? Few Mitotic figures - Features are favouring more Basal cell carcinoma Trichoepithelioma is a close Differential

section studied shows tumor cells arranged in nests,cords,they are basaloid cells having hyperchromatic nucleii,peripheral palisading and retraction artefacts,clear space b/w tumor cells nests and adjacent stroma,sclerosed blood vessels and cholesterol clefts are also seen. Impression -Basal cell Carcinoma

Basal cell carcinoma with follicular differentiation (Infundibulocystic bcc) D/D trichoepithelioma, trichoblastoma & other adnexal neoplasms.

Retraction artifacts n presence of mucin within epithelial nests and in surrounding stroma are s/o bcc

Looks like Basal cell carcinoma

BCC / Trichoepithelioma

Basal cell carcinoma but not atteched to epidermis,so probably arising from hair follicle.Tumour cell do not show intercellular bridges. Tumour is infiltrative in soft tissue.

DDs : ^BCC.*Trichoepithelioma.Advised IHC.

As per the photographs the neoplasm seems to be infiltrative in nature at least locally as it is seen in BBC. In this case there is peripheral palisading of cells with some degree of atypia. There is no true retraction spaces, moreover lots hair follicular structures are seen. The overall picture favours cutaneous adnexal t

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