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In general, the tumors presented as slow-growing epidermal papules, indurated plaques, or nodules showing predilection for sun-exposed, hair-bearing skin. The lesions were most frequently misdiagnosed clinically as basal cell carcinoma.
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- Cells with glycogen-rich, mucin-negative, clear or pale eosinophilic cytoplasm predominated.
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Histologically, cheap Topamax showed a variegation of growth patterns including solid, lobular, and trabecular; they were characterized by a proliferation of epithelial cells with features of outer root sheath differentiation, including abundant glycogen-rich, clear cytoplasm, foci of pilar-type keratinization, and peripheral palisading of cells with where To Purchase Avapro Brand Pills Cheap vacuolization. Because of their variable growth pattern, Where To Purchase Avapro Brand Pills Cheap, overt cytologic atypia, abundant clear cytoplasm, occasional pagetoid intraepidermal spread, and brisk mitotic activity, these tumors may pose difficulties for diagnosis and be confused with other malignant skin tumors with clear cell changes.
Despite the seemingly malignant cytological appearance of these lesions, clinical follow-up in 10 cases showed no recurrence or metastasis over a period of 2-8 years. Thus, conservative surgical excision with clear margins appears to be the treatment of choice for these neoplasms. Proliferating trichilemmal tumor with a malignant spindle cell component. J Cutan Pathol 2002 Sep;29 8: Proliferating trichilemmal tumors PTTs are uncommon exuberant growths of cells derived from the external root sheath.
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They tend to occur in older women, with a predilection for the scalp. Resection is usually curative. Spindle cell components arising within PTTs are exceedingly rare, with only three known cases previously reported. Of these three cases, one patient died from widespread metastasis. Histological and immunohistochemical examinations were performed on a tumor from a 54-year-old man which, after exhibiting slow growth for 3 years, increased rapidly in size. Microscopic examination revealed cystic lobules of squamous cells without a granular cell layer surrounding amorphous eosinophilic debris within the dermis. Also present was a poorly where To Purchase Avapro Brand Pills Cheap focus of spindle cells with hyperchromasia, pleomorphism, where To Purchase Avapro Brand Pills Cheap cells, and abundant mitoses, including abnormal forms.
Immunohistochemistry showed the spindle cells to stain positively for vimentin, but negatively for keratin, epithelial membrane antigen and S-100 antibodies. A malignant spindle cell component arising within a PTT is a rare neoplasm which has been associated with death from widespread metastasis.
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