Pathologic Quiz Case: An 84-Year-Old Woman With a Skin Cyst Containing Ziehl-Neelsen–Positive Structures

    March 2005 in “ Archives of Pathology & Laboratory Medicine ”
    Allison M. Law, Beth M. Rutland, Marcelo G. Horenstein
    TLDR Basal cell carcinoma may originate from vellus hair cysts.
    The document described a case of an 84-year-old woman with a skin cyst containing Ziehl-Neelsen–positive structures, diagnosed as basal cell carcinoma (BCC) associated with a vellus hair cyst (VHC). The study highlighted that BCC is the most common cutaneous malignant neoplasm, typically occurring in sun-exposed areas of fair-skinned individuals, but rarely associated with cysts. The case presented was unique as it was the first reported instance of BCC arising in association with a VHC. The findings suggested a potential vellus hair origin for BCC, supported by the tumor's connection to the infundibulum of the VHC and its outer root sheath. This association was not previously documented, indicating a novel area for further research into the histogenesis of BCC.
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