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.
    This document described a case of an 84-year-old woman with a skin cyst containing Ziehl-Neelsen–positive structures, diagnosed as a vellus hair cyst (VHC) associated with basal cell carcinoma (BCC). The study highlighted that the BCC was connected to the infundibulum of the VHC, suggesting a potential vellus hair origin for BCC. This association was considered novel, as BCCs are rarely documented to arise from cysts, and the connection between BCC and VHC had not been previously reported. The document also reviewed the historical and molecular perspectives on the histogenesis of BCC, emphasizing its differentiation pattern toward cells of the pilar nature.
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