Ultrasonic diagnosis of calcified epithelioma

Case profile:

Patient: Female, 37 years old, found a painless mass on the upper arm for more than half a year, with hard quality and poor mobility. The surface condition is as follows:

The bumps protrude from the skin surface, the surface is reddish, without pigmentation
Ultrasound image

Ultrasound findings: Hypoechoic masses were found in the dermis and subcutaneous layers of the masses, with clear borders, with hypoechoic surroundings visible around the masses, uneven internal echoes, strong spot-like echoes, and few and abundances at the base and periphery Blood flow signal.

Pathological diagnosis: sub-epidermal basophils and shadow cells are distributed in nests, interstitial fibrous tissues proliferate and vitreous, multinucleated foreign body giant cells are scattered, V-G staining: (+): consistent with calcified epithelioma.

Ultrasound diagnosis of calcified epithelioma:

Calcified epithelioma, also known as trichoblastoma, originates from the outer root sheath cells of hair follicles. It is a nodular benign tumor that occurs in the dermis and subcutaneous tissues. It can occur at any age, mainly in children and adolescents, and is more common in the head. Neck and upper limbs (in this case, the lesion occurred in the upper arm).

Clinical signs: It appears as a single, hard-textured, painless nodule, which sometimes leads to changes in skin color and texture (in this case, the lesion is mainly manifested as a slight reddening of the skin surface), which cannot dissipate by itself, and is usually treated by surgical resection .

Pathological features: Histologically, the lesion is located in the dermis and subcutaneous fat layer, composed of basophils, anucleated shadow cells, and transitional cells between the two. Calcification and ossification are the pathological features.

Ultrasound diagnosis:

① The tumor is located in the dermis and subcutaneous layer;

②It is mostly oval-like, with clear borders, and hypoechoic nodules with complete halo can be seen in part of the periphery;

③The internal echoes are often uneven. The punctate and patchy strong echoes in the internal examination are its characteristic manifestations. However, this characteristic manifestation does not occur in all the tumors, but the incidence is low, and attention should be paid to distinguish them.

④CDFI: There is no obvious blood flow signal inside the tumor, and the blood flow signal can be detected around it

(source:internet, reference only)

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