Pilomatricomas in children: imaging characteristics with pathologic correlation
Tóm tắt
Although pilomatricoma commonly occurs in children, there is still a poor understanding of the imaging characteristics of pilomatricoma and lack of agreement regarding its imaging findings and histopathologic features. To characterize the radiologic appearance of pilomatricomas on US, CT, and MR and to correlate the imaging findings with histopathologic features. The imaging findings of 47 pilomatricomas on US (n = 17), CT (n = 31), and MR (n = 5) were retrospectively evaluated. Pathologic specimens of all cases were reviewed and compared with imaging findings. All lesions were well-circumscribed, subcutaneous nodules with partial attachment to the overlying skin. On US, the lesions were mostly hyperechoic with posterior acoustic shadowing and hypoechoic rim. On CT, they appeared as enhancing soft-tissue masses with varying amounts of calcification. MR findings were internal reticulations and patchy areas on T2-weighted images and contrast-enhanced T1-weighted images, corresponding to edematous stroma on pathology. Peritumoral inflammatory changes and connective capsule on pathology were well correlated with imaging findings. Pilomatricoma should be considered when US or CT shows a well-defined hyperechoic or calcific nodule in subcutaneous fat attached to the skin in children. MR images may be helpful in diagnosis. Pathologic findings are well correlated with imaging findings.
Tài liệu tham khảo
Malherbe A, Chenantais J (1880) Note sur l’epitheliome calcifie des glandes sebacees. Prog Med 8:826–828
Kaddu S, Soyer HP, Cerroni L et al (1994) Clinical and histopathologic spectrum of pilomatricomas in adults. Int J Dermatol 33:705–708
Forbis R Jr, Helwig EB (1961) Pilomatrixoma (calcifying epithelioma). Arch Dermatol 83:606–618
Moehlenbeck FW (1973) Pilomatrixoma (calcifying epithelioma): a statistical study. Arch Dermatol 108:532–534
Knight PJ, Reiner CB (1983) Superficial lumps in children: what, when, and why? Pediatrics 72:147–153
Lan MY, Lan MC, Ho CY et al (2003) Pilomatricoma of the head and neck: a retrospective review of 179 cases. Arch Otolaryngol Head Neck Surg 129:1327–1330
Pirouzmanesh A, Reinisch JF, Gonzalez-Gomez I et al (2003) Pilomatrixoma: a review of 346 cases. Plast Reconstr Surg 112:1784–1789
Yencha MW (2001) Head and neck pilomatricoma in the pediatric age group: a retrospective study and literature review. Int J Pediatr Otorhinolaryngol 57:123–128
Masih S, Sorenson SM, Gentili A et al (2000) Atypical adult non-calcified pilomatricoma. Skeletal Radiol 29:54–56
Hughes J, Lam A, Rogers M (1999) Use of ultrasonography in the diagnosis of childhood pilomatrixoma. Pediatr Dermatol 16:341–344
Ulrich J, Wesarg I (2001) High-frequency ultrasound in the diagnosis of pilomatrixoma. Pediatr Dermatol 18:163
Hwang JY, Lee SW, Lee SM (2005) The common ultrasonographic features of pilomatricoma. J Ultrasound Med 24:1397–1402
Som PM, Shugar JM, Silvers AR (1998) CT of pilomatrixoma in the cheek. AJNR 19:1219–1220
Lee KH, Kim HJ, Suh CH (2000) Pilomatricoma in the head and neck: CT findings in three patients. J Comput Assist Tomogr 24:332–335
De Beuckeleer LH, De Schepper AM, Neetens I (1996) Magnetic resonance imaging of pilomatricoma. Eur Radiol 6:72–75
Ichikawa T, Nakajima Y, Fujimoto H et al (1997) Giant calcifying epithelioma of Malherbe (pilomatrixoma): imaging features. Skeletal Radiol 26:602–605
Hoffmann V, Roeren T, Moller P et al (1998) MR imaging of a pilomatrixoma. Pediatr Radiol 28:272
Sassmannshausen J, Chaffins M (2001) Pilomatrix carcinoma: a report of a case arising from a previously excised pilomatrixoma and a review of the literature. J Am Acad Dermatol 44:358–361
Fujioka M, Gozo N, Osamu M et al (2003) Secondary anetoderma overlying pilomatrixomas. Dermatology 207:316–318
Shames BS, Nassif A, Bailey CS et al (1994) Secondary anetoderma involving a pilomatricoma. Am J Dermatopathol 16:557–560
Moulin G, Bouchet B, Dos Santos G (1978) Anetodermic cutaneous changes above Malherbe’s tumors. Ann Dermatol Venereol 105:43–47
Kransdorf MJ, Meis-Kindblom JM (1994) Dermatofibrosarcoma protuberans: radiologic appearance. AJR 163:391–394
Kransdorf MJ, Murphery MD, Temple HT (1998) Subcutaneous granuloma annulare: radiologic appearance. Skeletal Radiol 27:266–270
Vandevenne JE, Colpaert CG, De Schepper AM (1998) Subcutaneous granuloma annulare: MR imaging and literature review. Eur Radiol 8:1363–1365