Pilar Kılıf Akantomu ve Dilate Por
Özet
Pilar Kılıf Akantomu ve Dilate Por (Winer), kıl folikülü farklılaşması gösteren iki farklı benign deri lezyonudur. Pilar Kılıf Akantomu (İnfundibuloistmikoma), genellikle yüz ve üst dudakta yerleşen, keratinöz materyal içeren santral bir ppora sahip küçük, soliter bir nodüldür. Histopatolojik olarak epidermis ile bağlantılı merkezi bir pordan dermise uzanan, glikojen içeren vakuolize pilar epitelden oluşmuş çok sayıda tümör lobülü ile karakterizedir; ayırıcı tanısında dilate por, trikofoliküloma ve fibrofoliküloma yer alır. Diğer taraftan Dilate Por, tipik olarak yetişkinlerin yüz veya boyun bölgesinde büyük bir komedon şeklinde ortaya çıkan yaygın bir lezyondur. Histolojisinde, dens lamellar keratin ile tıkanmış, kistik olarak genişlemiş bir kıl folikülü ve dermis içine doğru prolifere olan düzensiz akantotik infundibuler epitel kordonları izlenir; klinik ve histolojik olarak komedon ve nadiren bazal hücreli karsinom ile karışabilir.
Pilar Sheath Acanthoma and Dilated Pore of Winer are two distinct benign cutaneous lesions demonstrating hair follicle differentiation. Pilar Sheath Acanthoma (Infundibuloisthmoma) is a small, solitary nodule with a central pore containing keratinous debris, typically located on the face and upper lip. Histopathologically, it is characterized by multiple tumor lobules composed of vacuolated pilar epithelium extending into the dermis from a central pore connected to the epidermis; its differential diagnosis includes dilated pore, trichofolliculoma, and fibrofolliculoma. Conversely, Dilated Pore is a common lesion presenting as a large comedo, typically on the face or neck of adults. Histologically, it consists of a cystically dilated hair follicle plugged with dense lamellar keratin and lined by acanthotic infundibular epithelium proliferating into the dermis; it can be clinically and histologically confused with comedo and rarely basal cell carcinoma.
Referanslar
Hurt, M.A., Kaddu, S., Kutzner, H., Cribier, B., Schulz, T., & Hartschuh, W. (2006). Benign tumors with follicular differantiation. In Philip E. LeBoit(Ed.). World Health Organization classification of tumours - Pathology and genetics of skin tumours.(pp.157-158). Lyon: IARCPress.
Elder, D., Elenitsas, R., Ragsdale, B.D.(1997).Tumors of the Epidermal Appendages. In David Elder, R. Elenitsas, C. Jaworsky & B. Johnson Jr. (Eds.), Lever's Histopathology of the Skin (8nd ed., pp. 750). Philadelphia, PA: Lippincott-Raven Publishers.
Weedon, D., Strutton, G.(2002). Tumors of the Cutaneous Appendages. In David Weedon,G. Strutton (Eds.), Skin Pathology (2nd ed., pp. 954). London ; New York : Churchill Livingstone.
Calonje, E., Brenn, T., Lazar, A.,& McKee, P.H.( 2012). Tumors of the hair follicle.In Phillip H. McKee(Ed.), McKee's Pathology of The Skin: with Clinical Correlations. (4th ed., pp. 1448-1450). Philadelphia, PA: Elsevier/Saunders.
Elder, D., Elenitsas, R., Johnson Jr., B.(2007). Tumors and Cysts of the Dermis and Subcutis. In David Elder, R. Elenitsas, C. Jaworsky & B. Johnson Jr. (Eds.), Synopsis and Atlas of Lever's Histopathology of the Skin (2nd ed., pp. 326–327). Philadelphia, PA: Lippincott Williams & Wilkins.
Santa-Cruz, D.J., Walsh, S.N. (2007). Tumors of The Skin. In Christopher D.M. Fletcher (Ed.), Diagnostic Histopathology of Tumors. (4th ed., pp. 1703-1704). Philadelphia, PA: Elsevier Health Science.
Tellechea O, Cardoso JC, Reis JP, Ramos L, Gameiro AR, Coutinho I, Baptista AP. Benign follicular tumors. An Bras Dermatol. 2015 Nov-Dec;90(6):780-96; quiz 797-8. doi: 10.1590/abd1806-4841.20154114. PMID: 26734858; PMCID: PMC4689065.
Lee JY, Hirsch E. Pilar sheath acanthoma. Arch Dermatol. 1987 May;123(5):569-70. PMID: 3579335.
Benedetto CJ, Riley CA, Athalye L. Dilated Pore Of Winer. [Updated 2021 Sep 14]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2022 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK532967/
