女性，55岁，发现右前臂肿物3个月，肿物大小：2.0*1.5*1.0cm，包膜较完整，切面灰粉色，可见淡黄色小块状物。大家看一下能诊断为毛母质瘤癌变吗？

癌变的标准是什么？是不是有侵润啊，此例我觉得要没有包膜间质浸润，就不是癌

钙化上皮瘤

典型的钙化上皮瘤

恶性证据不足够，不过，图1上分裂像很多。增生活跃，随访吧。

钙化上皮瘤  增生活跃，随访吧。

钙化上皮瘤，典型！

 This is a benign tumor, not malignant. It is a Pilomatrixoma (Calcifying epithelioma of Melherbe)

钙化上皮瘤

钙化上皮瘤。本人最近遇见一例其中含大量骨质。

钙化上皮瘤  增生活跃，随访吧。

Pilomatrixoma

Also called pilomatricoma, calcified epithelioma of Malherbe

Benign tumor arising from hair matrix

Usually children and young adults in head, neck or upper extremities

Gross: nodular, subepidermal

Micro:

l         solid nests of basaloid cells undergoing abrupt trichilemmal-type keratinization;

l         ghost cells, often foreign body reaction, calcification or 0ssification with extramedullary hematopoiesis;

l         occasional transepidermal perforation

DD: basal cell carcinoma

Aggressive pilomatrixoma:

l         atypical histology,

l         locally invasive with local recurrence

Malignant pilomatrixoma:

l         cytologic atypia,

l         infiltrative border,

l         transitions to squamous cells;

l         clear cells,

l         necrosis,

l         mitotic figures,

l         variable sarcomatoid features;

l         commonly recur locally, may metastasize

本例部分区域细胞丰富，并见核分裂，关键是边缘有没有浸润性生长，如果边缘没有浸润性生长也只能报“钙化上皮瘤  增生活跃，随访”

钙化上皮瘤