Journal of Pathology and Translational Medicine

Case Reports

Trichogerminoma: A case report.: Sung Suk Paeng, Jin Hee Sohn, Duck Hwan Kim, Hee Jin Chang, Jung Il Suh, Kye Yong Song; Korean J Pathol. 1996;30(4):340-343.

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Abstract PDF: Though trichogenic tumors were classified as trichoblastoma, trichoblastic fibroma, trichogenic trichoblastoma and trichogenic myxoma by Headington(1970), their true classification depends upon the epithelial and mesodermal component as well as evidence of their induction. Because of the rarity of hair germ cell tumors their classification is still controversial. In this report, we describe a case of trichogerminoma which is not included in the above classification. The trichogerminoma was first described by Sau et al. in 1992 and characterized by its morphologic pattern of germinal centers and lymphoid follicle-like structures in the nests of trichoblasts. Herein we reporte a tumor which arose on the skin on the back of a 51-year-old man and presented as a sharply circumscribed mass(4.5x2.0x1.5 cm) involving both the dermal and subcutaneous tissues without any epidermal connection. The tumor had many germinal center-like structures in the basaloid trichoblasts. Lobular cell nests were separated by variable amounts of stroma, but no horn cyst were noted. The germinal center-like cells showed early differentiation of hairs, resembling early hair bulbs. Trichogerminoma is considered to be a type of tumor located between trichoblastoma and trichoblastic fibroma.

Hairy Polyp of Soft Palate in an Infant.: Kyeongmee Park, Yeonmee Kim, Hoonyoung Woo; Korean J Pathol. 1998;32(12):1101-1103.

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Abstract: Hairy polyp is an uncommon lesion of the nasopharynx and oropharynx. It is most frequently seen as a pedunculated mass at birth or in the first year of life. It generally has been classified as dermoid derived from the ectoderm and mesoderm. The symptoms depend on the size and location of the lesion. We report the clinico-pathological features of a hairy polyp arising from the right nasopharyngeal side of soft palate in a 21-day-old girl. Grossly, a well demarcated brownish yellow solid mass, measuring 2.7x1.5x1.2 cm, showed fine hairs on the surface. The cut surface was a yellowish brown solid appearance. Microscopically, it was covered with keratinizing squamous epithelium and was composed of mature adipose tissue, skeletal muscle, a few peripheral nerve bundles, and blood vessels in the center and mature pilosebaceous units in the periphery. Knowledge of this type of malformation facilitates early intervention and avoids significant morbidity.

Trichoblastic Carcinoma arising in Trichoblastoma: A Case Report.: Kyung Jin Seo, Jinyoung Yoo, Seok Jin Kang, Ji Han Jung, Hye Kyung Lee, Kyo Young Lee; Korean J Pathol. 2007;41(4):274-277.

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Abstract PDF: Trichoblastic carcinoma is a rare malignant neoplasm of follicular germ cell origin; to the best of our knowledge, only six trichoblastic carcinomas arising in trichoblastomas have appeared on the literature. We recently experienced a trichoblastic carcinoma arising in a long standing trichoblastoma. A 68-year old woman came to the hospital with a chief complaint of an ulcerated nodule on her face. The nodule, 1.1x0.9 cm with an asymmetrical configuration, had been present and unchanged for more than 20 years, however, it grew suddenly with painful burning sensation. An excisional biopsy was performed and disclosed a deeply invasive, highgrade carcinoma, which consisted of cohesive epithelial cells arranged in irregular plump or germinative cell nests of various sizes. However, at the periphery of the tumor was a benign trichoblastoma surrounded by perifollicular sheath. We believe that the present case is a trichoblastic carcinoma developed via malignant transformation of pre-existing trichoblastoma.

Pigmented Trichogerminoma: A Case Report.: Jung Ha Shin, Ji Han Jung, Jinyoung Yoo, Seok Jin Kang, Kyo Young Lee; Korean J Pathol. 2007;41(3):187-189.

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Abstract PDF: Trichogerminoma is a rare cutaneous adnexal tumor that dysplays differentiation toward the hair germ epithelium. This tumor was first described by Sau et al. in 1992 and it is characterized by densely packed round nests or cell balls resembling hair bulbs. Herein, we report on a deeply pigmented and sharply circumscribed nodular tumor that was excised on the abdomen of a 48-year-old woman. Histologically the tumor involved both dermis and subcutis without any epidermal connection. The main nodule was subdivided into the smaller lobules by fibrous stroma. The lobules were composed of masses of basaloid cells that displayed peripheral palisading. Within the lobules, the basaloid cells formed numerous cell balls. The tumor presented the characteristic features of trichogerminoma. Interestingly, our case was the pigmented type, which was remarkable by virtue of the heavy melanin deposits found within and around the tumor nests. To the best of our knowledge, this is the first case of pigmented trichogerminoma that has been reported worldwide.

Hairy Cell Leukemia: A case report.: Jae Gul Chung, Gyung Yub Gong, Ghee Young Choe, Eun Sil Yu, In Chul Lee, Kun Choon Park, Sang Hee Kim; Korean J Pathol. 1994;28(6):675-677.

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Abstract PDF: Hairy cell leukemia is an uncommon lymphoreticular disorder which primarily involves bone marrow, spleen, and peripheral blood. Patients, mostly men, present with splenomegaly and pancytopenia usually. A 62-year-old man was admitted with an abdominnal mass which had grown slowly for 20 years. On physical examination, an enlarged spleen was palpated without tenderness. An abdominal CT scan showed a diffusely enlarged spleen, which measured 20 cm in greatest dimension. In the peripheral blood, many atypical lymphocytes with abundant, delicate, surface projections were noted. They had tartrate-resistant acid phosphatase(TRAP) activity. Thrombocytopenia (60,000/mm3) was observed in the complete blood counts, Other laboratory data were within normal limits. He underwent splenectomy. The submitted spleen measured 26x15x5 cm and weighed 2150 gm. It was well encapsulated and the outer surface was smooth. Cut surfaces were diffusely dark-red. White and red pulps were indistinct. There was no mass-like lesion. Microscopically, the spleen consisted of monotonous mononulcear cells which involved red pulp. The white pulp was diminished, and could be barely recognized. Cells had small round nuclei and abundant cytoplasm. Ultrastructurally, cells with numerous slender surface projections were noted. In Korea, hairy cell leukemia is exceedingly rare. We report a case of hairy cell leukemia with characteristic pathologic features of spleen as well as those of peripheral blood.

Trichofolliculoma: A case report.: Su Kyeong Yeon, Ki Hwa Yang, Seok Jin Kang, Sun Moo Kim; Korean J Pathol. 1994;28(1):79-81.

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Abstract PDF: The trichofolliculoma is a rare tumor of the hair follicle occuring most often on the head and neck. We have experienced a case of 24-year-old female who had a small, dome-shaped, tan brown firm nodule on the nose. Under the clinical impression of a granuloma, an excisional biopsy of the nodule was done. Microscopically the lesion was composed of a large central cystic hair follicle with many srhall but well differenciated secondary hair follicles branching from the wall. Well developed secondary hair follicles were often grouped and were surrounded by a prominent stroma.

Original Articles

Scanning Electron Microscopic Findings of Hair Anomalies.: Chul Jong Yoon, Je G Chi, Hai Won Chung; Korean J Pathol. 1993;27(5):491-500.

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Abstract PDF: Scanning electron microscopic(SEM) examination of hair is an efficient and definite method for the diagnosis of hair anomaly. The Hair specimen is placed on a stub, gold coated, and directly viewed without prior fixation or treatment for identification. We have analyzed 25 cases of scalp hair and 2 cases of eyebrow that were sampled with the suspicion of hair anomalies at Seoul National University Hospital during the last 7 year period from January 1988 to June 1992. All 27 cases had certain abnormalities of the hair. They consisted of monilethrix(1 case), hair casts(4 cases), pili torti(1 case), uncombable hair syndrome(1 case), trichorrhexis nodosa(5 cases), woolly hair(5 cases) and other anomaly(1 case). Some cases of them were mixed with two or three anomalies in hairs. Their combinations were; hair casts and woolly hair(1 case), hair casts and pili torti and uncombabla hair syndrome(1 case), hair casts and uncombable hair syndrome and trichorrhexis nodosa(1 case), trichorrhexis nodosa and uncombable hair syndrome(3 cases). Most of these defects included brittleness of scales and distortion of the hair shaft.

Morphological Observations on the Hair Development of Human Fetal Skin.: Kil Seo Kim, Joong Seok Seo, Key Yong Song, Je G Chi; Korean J Pathol. 1990;24(1):39-49.

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Abstract PDF: The developing process of the hair of the fetal skin was studied. The ages of 103 human embryos and fetuses ranged from 4 to 40 gestation weeks. Ten different sites were selected, i.e., scalp, forehead, cheek, chest, abdomen, back, palm, sole, finger and toe. For the embryos 3 sites were studied, i.e., cephalic, trunk, and caudal portions. Following results were made: 1) The primitive hair germ was first noted the 10th week in the face skin as nubbins of mesenchymal cells beneath discrete foci of crowdes, elongated germinative epithelial cells. The developing hair germs and hair pegs were observes at the cephalic portion by 11 weeks. At 15 weeks the hair pegs including hair germs were noted in the trunk skin. The bulbous hair peg stage started at the 16th week in the cephalic portion and at the 18th week in the trunk. 2) Relative number of fetal hairs progressively increase up to 20 weeks of gestation but, thereafter decreased although it was different by the site of the body. 3) The diameter of fetal hair follicles increased with fetal age to the term with slight difference by the portion of body. 4) The developmental process of hair was more rapid in the cephalic portion than the trunk in views of morphologic changes of the hair structures, number and diameter of hair follicles.

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