Fine-needle aspiration of pilomatrixoma

Pilomatrixoma in an infant: diagnostic challenges of fine-needle aspiration

Fine-needle aspiration biopsy (FNAB) is a well-recognized minimally invasive tool in the diagnosis of neoplasia of various organ systems. Several reports in the literature suggest that FNAB can be an accurate method for the preoperative diagnosis and treatment planning. We describe a case to caution the interpretation from a FNAB that contains suboptimal contents (basaloid cells only) and highlight a clinical-pathologic-based algorithm that can provide the appropriate management for the patient when the cytopathologic diagnosis does not fit the clinical impression.

Pilomatricoma of the Maxillofacial Area in the Northern Regional Jordanian Population: Report of 31 Cases

PURPOSE

To analyze the clinicopathologic features of pilomatricoma affecting the maxillofacial area in Jordanians.

PATIENTS AND METHODS

Records of the Department of Pathology at Jordan University of Science and Technology were reviewed for patients with biopsied pilomatricoma of the maxillofacial region received during the 11-year period extending between 1991 and 2001. These were retrieved, reviewed, and analyzed for age, gender, location, clinical features, and treatment.

RESULTS

There were 31 cases with an age range from 4 to 48 years (mean, 16.7). The majority (74%) of patients were in their first (45%) and second (29%) decades of life with a male to female ratio of 1 to 1.4. The periorbital (36%), the periauricular (28%), and the upper cervical region (23%) were the affected areas. The majority of cases presented as a painless skin nodule with a duration varying from 2 months to 3 years. The majority (97%) of tumors were between 0.5 cm and 2 cm in diameter. Histologically, almost 50% of tumors showed shadow cells alone. All tumors were removed surgically.

CONCLUSIONS

The clinicopathologic characteristics of pilomatricoma of the maxillofacial area in Jordanians are similar generally to those in other countries. Maxillofacial surgeons need to be more aware of this lesion and should consider it in the differential diagnosis of dermal masses they encounter.

Pilomatrixoma: clinicopathologic study of 51 cases with emphasis on cytologic features

The clinical and pathologic features of 51 cases of pilomatrixoma found in our archives from 1990-1999 were reviewed, with emphasis on the cytopathologic features of the 22 cases that were sampled by fine-needle aspiration (FNA) biopsy prior to excision. Although uncommon, almost 20% of the pilomatrixomas in this series occurred in adults over age 30. Of the commonly reported features, the presence of basaloid cells and ghost cells in FNA smears, associated with a cutaneous location of the lesion, was sufficient for a confident cytologic diagnosis of pilomatrixoma. The presence of foreign body-type giant cells, nucleated squamous cells, and calcification, alone or in combination, was less specific, but supported a diagnosis of pilomatrixoma. Although infrequently reported, prominent nucleoli in basaloid cells and smears containing refractile keratin clumps were very useful clues in the diagnosis of pilomatrixoma. Finally, the routine use of cell blocks is recommended because in many of the cases presented ghost cells were fragmented or obscured in smears, but were more readily identified in cell block sections.