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Published on: January 7, 2016
Cutaneous changes in fibrous hamartoma of infancy
1Department of Pathology, University of British Columbia, British Columbia, Canada.
Insights
Fibrous hamartoma of infancy (FHI) often shows changes in the overlying skin, specifically eccrine gland alterations. This finding can aid in diagnosing FHI, particularly with superficial biopsies.
Area of Science:
- Pediatric Pathology
- Dermatopathology
- Soft Tissue Tumors
Background:
- Fibrous hamartoma of infancy (FHI) is a rapidly growing soft tissue tumor typically affecting children under two years old.
- While FHI histology is documented, research on associated epidermal and skin appendage changes is limited.
Purpose of the Study:
- To investigate changes in the epidermis and skin adnexae in cases of fibrous hamartoma of infancy.
- To determine if these cutaneous changes can serve as diagnostic clues for FHI.
Main Methods:
- A retrospective review of 13 surgically excised fibrous hamartoma of infancy (FHI) cases was conducted.
- Histological sections including overlying epidermis were examined for changes in skin adnexae.
Main Results:
- All five cases with intact epidermis demonstrated eccrine gland changes, including hyperplasia and duct alterations.
- Specific findings included intraluminal papillary formations and squamous syringometaplasia.
- One case exhibited epidermal basaloid follicular hyperplasia.
Conclusions:
- Eccrine gland alterations are frequently observed in fibrous hamartoma of infancy (FHI) when the overlying skin is included in the biopsy.
- These findings suggest that eccrine changes may be a valuable diagnostic indicator for FHI, especially in superficial biopsies.
Background:
Fibrous hamartoma of infancy (FHI) is a fast growing soft tissue tumor that usually arises in the first 2 years of life. The histology of the lesion has been well described. Few studies, however, have looked at changes in the overlying skin and its appendages.
Methods:
A database search performed at British Columbia Children's Hospital yielded 15 cases of unequivocal FHI occurring in 12 patients (three were recurrences). Of these, we were able to retrieve 13. Five of 13 cases had sections including epidermis. These slides were reviewed with specific emphasis on skin adnexae.
Results:
Of the cases with excised epidermis in continuity with the lesion, 5/5 had eccrine changes, including hyperplasia, duct dilatation, intraluminal papillary formations, and squamous syringometaplasia. One case showed epidermal basaloid follicular hyperplasia.
Conclusions:
This study shows that eccrine changes are frequently seen in cases of FHI when overlying skin is sampled. This may be a useful clue to consider this diagnosis, especially when the biopsy is superficial.
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