A case of pilomatricoma with suspected malignancy diagnosed by intraoperative rapid cytological diagnosis

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  • YOSHIDA-TANAKA Miho
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • KURAOKA Kazuya
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center Department of Clinical Laboratory, National Hospital Organization Kure Medical Center and Chugoku Cancer Center Department of Institute for Clinical Research, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • YASUMURA Naoko
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • KAN Arisa
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • SAIKI Yumi
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • KAGAWA Akihiro
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • SAITO Akihisa
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center
  • TANIYAMA Kiyomi
    Department of Diagnostic Pathology, National Hospital Organization Kure Medical Center and Chugoku Cancer Center

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Other Title
  • 迅速細胞診断時悪性病変が疑われた毛母腫の 1 例

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<p>Background : Pilomatricoma is a benign skin appendage tumor. This tumor is frequently misdiagnosed by skin cytology as a malignant tumor.</p><p>Case : A one-year-old girl was brought to us with a mass in front of her left ear. Findings of MRI and fine needle aspiration cytology performed at another hospital led to the suspicion of malignant lymphoma. Subsequently, she was referred to our hospital, and surgical resection of the tumor was performed.</p><p>Cytological diagnosis : The specimens showed an uneven distribution of atypical cells and a slightly hemorrhagic background. The atypical cells were isolated or occurred in 3-D clusters, and had naked nuclei with indistinct cell borders, mimicking the features of basaloid cells. A few shadow cells and multinucleated giant cells were found admixed with the basaloid cells. Based on the findings, we made the diagnosis of pilomatricoma.</p><p>Histological findings : The resected subcutaneous tumor was a fragile mass. The tumor contained acidophilic cells, basophilic cells, shadow cells, and multinucleated giant cells. The tumor was diagnosed as a pilomatricoma.</p><p>Conclusion : In a child or adolescent presenting with a cutaneous nodular lesion, a high cell density of basaloid cells is suggestive, and the presence of shadow cells is helpful, for making a diagnosis of pilomatricoma.</p>

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