S11C28P23-Molluscum

S11C28P23-1: One mature follicle (red arrow), two abortive follicles (blue arrows), and two follicle-like lesions of molluscum contagiosum (MC) (green arrows) are represented in this field. It is of interest that the two MC lesions have the same basic configuration and extend to a comparable depth in the dermis, as the mature follicle. They have follicle-like qualities and even bulge where a follicle should bulge. There are too many follicular structures per unit area; this crowding of follicles is in keeping with the interpretation that there has been follicular neogenesis in this lesion. The interpretation can be extended with the suggestion that the peculiar, watery stroma of a lesion of molluscum contagiosum is a hyperplastic follicular sheath, and that this overgrowth of follicular stroma participates with epithelium in the process of follicular neogenesis. The viral infection of the epidermis may induce the stromal changes, and the stromal overgrowth, in turn, induces follicular neogenesis even in sites that, by histologic criteria, are not virally affected.

S11C28P23-2: Green arrows identify areas of follicular neogenesis. There is overgrowth of a distinctive stroma (it is sometimes possible to diagnose molluscum contagiosum on the basis of the stromal changes, even if the epithelial component is not represented in the plane of the section). The red arrow, to the left, identifies an abortive hair bulb at the extremity of a MC lesion; it is symmetrically placed in relationship to the epithelial bulges (yellow arrows) on either side of the bulb.

S11C28P23-3: At a higher magnification, an abortive hair bulb (green arrows) protrudes from the extremity of the MC lesion. It shows peripheral palisading of nuclei; it is outlined by a thickened basement membrane.

S11C28P23-4: Along the epithelial lining of this cystic MC lesion, cords of basaloid cells protrude into the neighboring stroma. The protrusions show a peripheral row of palisaded nuclei; they are outlined by a thickened basement membrane (abortive follicular neogenesis).

S11C28P23-5: At the margin of this cystic MC lesion, the epithelial lining shows an area in which the pattern of the cells mimics that of follicular epithelium. The basement membrane in this area is thickened and hyalinized. The distinctive stroma of polypoid MC lesions is represented on the right.

 

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