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WHO Classification of Tumours
Follicular fibroma
Skin


Definition

Follicular fibroma (late stages are termed trichodiscoma) is a rare, benign appendageal neoplasm with differentiation towards the mantle of the hair follicle. It arises preferentially on the face, neck and chest and presents as a small (2-4mm), skin-coloured, smooth, dome-shaped papular lesion. Confluence of single lesions may occur, resulting in plaques measuring up to several cm
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Schulz T, Ebschner U, Hartschuh W (2001)
Localized Birt-Hogg-Dubé syndrome with prominent perivascular fibromas.
Am J Dermatopathol 23: 149-53



. Multiple lesions are a hallmark of the inherited Birt-Hogg-Dubé syndrome .
Histologically, follicular fibromas / trichodiscomas are characterized by epithelial and mesenchymal elements. The dilated infundibulum gives rise to anastomosing cords and strands of epithelium. The epithelial cords often contain cells with sebaceous differentiation. One to several infundibulocystic structures are surrounded by a prominent, vascularized, often mucinous stroma composed of fine bundles of collagen and containing numerous spindled fibrocytes. In trichodiscomas, the stromal periphery may contain sebaceous lobules. The stroma is separated from the normal dermis by clefts.
Follicular fibromas typically arise in the 3rd to 4th decades of life. The tumours are benign and excised mainly for cosmetic reasons

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LeBoit PE, Burg G, Weedon D, Sarasin A (Eds.)
World Health Organization Classification of Tumours. Pathology and Genetics of Skin Tumours
3rd Edition
IARC Press: Lyon 2005



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