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Pathology of Tumour of the

Follicular Infundibulum 

Dr Sampurna Roy MD      




Tumour of the follicular infundibulum (TFI)  is an uncommon benign neoplasm manifested histopathologically by a superficial epithelial plate-like growth pattern with multiple thin epidermal connections comprised of monomorphic cells with abundant cytoplasm.

Clinically, presents as a small asymptomatic, smooth or slightly keratotic papule or plaque.

The two main clinical variants are :

1) Solitary:  Presents as a solitary keratotic papule.

2) Multiple

Classified as:

(1) solitary tumours,

(2) eruptive tumours,

(3) TFI - associated with other lesions of Cowden's disease,

(4) TFI- associated with a single tumour such as nevus sebaceus, and

(5) TFI-like epidermal changes.

Sites:  Head and neck or upper chest.

Microscopic features:


Symmetrical tumour with plate-like growth pattern of the squamous cell (similar to isthmic or outer root sheath epithelium) parallel to the surface epithelium ;

Multiple attachments to the epidermis ;

Basal cell palisade ;

Acanthotic epithelium eosinophilic and pale staining than the overlying epidermis ;

Small ducts and microcavities with keratin in the lesion; PAS- positive basement membrane.

Visit: Cowden's syndrome


Differential diagnosis: 

Inverted follicular keratoses ; 

Trichilemmomas  ; 

Plaque-like seborrheic keratosis ;   

Superficial basal cell carcinoma; 

Multiple infundibular tumors of the head and neck.  


Further reading:

Solitary and multiple tumors of follicular infundibulum: a review of 168 cases with emphasis on staining patterns and clinical variants.

Eruptive tumors of the follicular infundibulum presenting as hypopigmented macules on the buttocks of two Black African males.

A case of tumor of the follicular infundibulum with sebaceous differentiation.

Tumor of follicular infundibulum is Basal cell carcinoma.

Tumor of the follicular infundibulum: an epidermal reaction pattern?

Vitiligoid hypopigmented macules and tumor of the follicular infundibulum.

Multiple tumors of the follicular infundibulum. 

Coexistence of tumor of the follicular infundibulum with an unusual trichilemmal tumor.

Clinicopathological report Periocular tumour of the follicular infundibulum.




Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)








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