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Pathology of Desmoplastic


Dr Sampurna Roy MD      





Desmoplastic trichilemmoma, is a pseudomalignant variant of trichilemmoma.

Clinical presentation: Occurs in men after the fifth decade of life and presents as a small solitary nodule on the face.

It is frequently misdiagnosed clinically as a basal cell carcinoma or a papilloma.

Microscopic features: 


Characterized by extensive sclerotic stromal component together with complex strands of clear epithelial cell in the periphery ;

Desmoplastic changes are present in the deep and central portion of the lesion ;

Stroma is also present in the centre of epithelial nodules ;

Eosinophilic, amorphous alcian blue and PAS-diastase positive material is present (basement membrane material) ;

CD34 positive cells are identified ; Stroma contains vimentin positive cells.

Differential diagnosis:

Inverted seborrheic keratosis ;

Spindle cell squamous cell carcinoma and desmoplastic basal cell carcinoma (spindle cell component in desmoplastic trichilemmoma merge with surrounding stroma, resembling infiltrating carcinoma).

Related post: Pathology of Trichilemmoma


Further reading:

Desmoplastic trichilemmoma: a rare tumor of the eyelid.

Desmoplastic trichilemmoma of the facial region mimicking invasive carcinoma.

A case of desmoplastic trichilemmoma of the lip treated with Mohs surgery.

Desmoplastic trichilemmoma arising within a nevus sebaceus.

Diagnostic value of CD34 immunostaining in desmoplastic trichilemmoma.

Desmoplastic trichilemmoma: a case report with immunohistochemical characterization of the extracellular matrix components.

Basal cell carcinoma arising in association with desmoplastic trichilemmoma.

Desmoplastic trichilemmoma.

Desmoplastic trichilemmoma: histologic variant resembling invasive carcinoma.

Desmoplastic trichilemmoma: a rare tumor of the eyelid.





Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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