Difference between revisions of "Dermatologic neoplasms"
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This article deals with '''dermatologic neoplasms'''. It includes '''dermatologic cancer''', which can be deadly. Collectively, dermatologic cancers are the most common form of cancer. | This article deals with '''dermatologic neoplasms''', also known as '''skin tumours'''. It includes '''dermatologic cancer''', which can be deadly. Collectively, dermatologic cancers are the most common form of cancer. | ||
An introduction to dermatopathy is found in the ''[[dermatopathology]]'' article. Non-malignant disease is covered in the ''[[non-malignant skin disease]]'' article. | An introduction to dermatopathy is found in the ''[[dermatopathology]]'' article. Non-malignant disease is covered in the ''[[non-malignant skin disease]]'' article. | ||
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=The Big Three malignant= | =The Big Three malignant= | ||
==Basal cell carcinoma== | ==Basal cell carcinoma== | ||
{{Main|Basal cell carcinoma}} | |||
==Squamous cell carcinoma of the skin== | |||
*Abbreviated ''skin SCC'', ''SCC of the skin'', and ''SCC of skin''. | |||
{{Main|Squamous cell carcinoma of the skin}} | |||
* | |||
{{Main|Squamous | |||
==Melanoma== | ==Melanoma== | ||
{{Main|Malignant melanoma}} | {{Main|Malignant melanoma}} | ||
*Known as the great mimicker in pathology; it may look like many things. | *Known as the great mimicker in pathology; it may look like many things. | ||
=Less common malignant= | =Less common malignant= | ||
==Dermatofibrosarcoma protuberans== | ==Dermatofibrosarcoma protuberans== | ||
*Abbreviated ''DFSP''. | *Abbreviated ''DFSP''. | ||
{{Main|Dermatofibrosarcoma protuberans}} | |||
==Cutaneous B-cell lymphoma== | ==Cutaneous B-cell lymphoma== | ||
Line 266: | Line 36: | ||
==Cutaneous T-cell lymphoma== | ==Cutaneous T-cell lymphoma== | ||
*Abbreviated CTCL. | *Abbreviated CTCL. | ||
{{Main|Cutaneous T-cell lymphoma}} | |||
==Merkel cell carcinoma== | |||
{{Main|Merkel cell carcinoma}} | |||
==Eccrine carcinoma== | |||
===General=== | ===General=== | ||
* | *Arises from the proximal sweat duct. | ||
===Microscopic=== | ===Microscopic=== | ||
Features: | |||
** | *Pleomorphic nuclei with nucleoli. | ||
*Duct-like structures - '''key feature'''. | |||
*Extends from dermis into epidermis (follows path of a benign sweat duct). | |||
* | |||
Notes: | |||
*[[ | *May resemble [[Extramammary Paget's disease]]/[[Paget's disease of the breast]]. | ||
==Kaposi sarcoma== | |||
:See ''[[Kaposi sarcoma]]''. | |||
=== | ==Sebaceous carcinoma== | ||
{{Main|Sebaceous carcinoma}} | |||
==Microcystic adnexal carcinoma== | |||
{{Main|Microcystic adnexal carcinoma}} | |||
==Trichilemmal carcinoma== | |||
{{Main|Trichilemmal carcinoma}} | |||
==Lymphomatoid papulosis== | ==Lymphomatoid papulosis== | ||
Line 325: | Line 84: | ||
*CD30 +ve.<ref>URL: [http://path.upmc.edu/cases/case513/dx.html http://path.upmc.edu/cases/case513/dx.html]. Accessed on: 25 January 2012.</ref> | *CD30 +ve.<ref>URL: [http://path.upmc.edu/cases/case513/dx.html http://path.upmc.edu/cases/case513/dx.html]. Accessed on: 25 January 2012.</ref> | ||
== | =Rare malignant= | ||
==Basosquamous carcinoma== | |||
:Should '''not''' be confused with ''basaloid [[squamous cell carcinoma]]'' ([[AKA]] ''squamous cell carcinoma, basaloid variant''). | |||
===General=== | ===General=== | ||
* | *Very rare. | ||
* | **Largest case series, as of 2000, 35 cases.<ref name=pmid10717618>{{Cite journal | last1 = Martin | first1 = RC. | last2 = Edwards | first2 = MJ. | last3 = Cawte | first3 = TG. | last4 = Sewell | first4 = CL. | last5 = McMasters | first5 = KM. | title = Basosquamous carcinoma: analysis of prognostic factors influencing recurrence. | journal = Cancer | volume = 88 | issue = 6 | pages = 1365-9 | month = Mar | year = 2000 | doi = | PMID = 10717618 }} | ||
* | |||
</ref> | </ref> | ||
*May be considered an aggressive variant of [[basal cell carcinoma]].<ref name=pmid10717618/> | |||
*Aggressive behaviour.<ref name=pmid12859383>{{Cite journal | last1 = Bowman | first1 = PH. | last2 = Ratz | first2 = JL. | last3 = Knoepp | first3 = TG. | last4 = Barnes | first4 = CJ. | last5 = Finley | first5 = EM. | title = Basosquamous carcinoma. | journal = Dermatol Surg | volume = 29 | issue = 8 | pages = 830-2; discussion 833 | month = Aug | year = 2003 | doi = | PMID = 12859383 }}.</ref> | |||
* | |||
* | |||
===Microscopic=== | ===Microscopic=== | ||
Features: | Features: | ||
* | *Has features of both [[basal cell carcinoma]] and [[squamous cell carcinoma of the skin|squamous cell carcinoma]].<ref name=pmid12859383/> | ||
* | **BCC component usually predominant.<ref name=Ref_Derm397>{{Ref Derm|397}}</ref> | ||
Note: | |||
* | *''Busam'' notes that there is disagreement about what defines this tumour;<ref name=Ref_Derm372>{{Ref Derm|372}}</ref> however, he goes on the describe it as a ''[[collision tumour]]''.<ref name=Ref_Derm397>{{Ref Derm|397}}</ref> | ||
DDx: | DDx: | ||
* | *Basaloid [[squamous cell carcinoma]]. | ||
*[[Basal cell carcinoma]] with squamous differentiation. | |||
*[[Basal cell carcinoma]] | |||
=Intermediate= | =Intermediate= | ||
==Atypical fibroxanthoma== | ==Atypical fibroxanthoma== | ||
*Abbreviated ''AFX''. | *Abbreviated ''AFX''. | ||
{{Main|Atypical fibroxanthoma}} | |||
=Benign= | =Benign= | ||
Line 500: | Line 116: | ||
*Benign sweat duct tumour. | *Benign sweat duct tumour. | ||
*Eccrine differentiation. | *Eccrine differentiation. | ||
*Usually close to lower eyelid.<ref>{{Ref PBoD8|1177}}</ref> | *Usually close to lower [[eyelid]].<ref>{{Ref PBoD8|1177}}</ref> | ||
===Microscopic=== | ===Microscopic=== | ||
Line 506: | Line 122: | ||
*Proliferation of benign ducts with lined by a bilayer (as in normal sweat ducts) with abnormal architecture: | *Proliferation of benign ducts with lined by a bilayer (as in normal sweat ducts) with abnormal architecture: | ||
**Tadpole like appearing ducts. | **Tadpole like appearing ducts. | ||
DDx: | |||
*Syringomatous adenomas of nipple (AKA syringoma of the nipple).<ref name=pmid22355740>{{Cite journal | last1 = Boecker | first1 = W. | last2 = Junkers | first2 = T. | last3 = Reusch | first3 = M. | last4 = Buerger | first4 = H. | last5 = Korsching | first5 = E. | last6 = Metze | first6 = D. | last7 = Decker | first7 = T. | last8 = Loening | first8 = T. | last9 = Lange | first9 = A. | title = Origin and differentiation of breast nipple syringoma. | journal = Sci Rep | volume = 2 | issue = | pages = 226 | month = | year = 2012 | doi = 10.1038/srep00226 | PMID = 22355740 |URL = http://www.nature.com/srep/2012/120117/srep00226/full/srep00226.html }}</ref> | |||
*[[Chondroid syringoma]]. (???) | |||
Images: | Images: | ||
Line 529: | Line 149: | ||
Images: | Images: | ||
*[ | *[https://www.dermnetnz.org/topics/apocrine-mixed-tumour-pathology Chondroid syringoma (DermnetNZ)]. | ||
==Dermal cylindroma== | ==Dermal cylindroma== | ||
{{Main|Dermal cylindroma}} | |||
==Keratoacanthoma== | ==Keratoacanthoma== | ||
{{Main|Keratoacanthoma}} | |||
==Sebaceous adenoma== | ==Sebaceous adenoma== | ||
===General=== | ===General=== | ||
*Seen in [[Muir-Torre syndrome]] - a variant of [[Lynch syndrome]] (hereditary non-polyposis colon cancer). | *Seen in [[Muir-Torre syndrome]] - a variant of [[Lynch syndrome]] (hereditary non-polyposis colon cancer). | ||
Notes: | |||
*Sebaceous lesions (from benign to malignant): [[sebaceous hyperplasia]], sebaceous adenoma, sebaceoma, [[sebaceous carcinoma]]. | |||
===Microscopic=== | ===Microscopic=== | ||
Line 587: | Line 170: | ||
**Multiple dilated glands - opening to the surface. | **Multiple dilated glands - opening to the surface. | ||
Images | ====Images==== | ||
<gallery> | |||
Image:Sebaceous_adenoma_-_low_mag.jpg | Sebaceous adenoma - low mag. (WC/Nephron) | |||
Image:Sebaceous_adenoma_-_high_mag.jpg | Sebaceous adenoma - high mag. (WC/Nephron) | |||
</gallery> | |||
www: | |||
*[http://dermatlas.med.jhmi.edu/derm/indexDisplay.cfm?ImageID=587283984 Sebaceous adenoma (jhmi.edu)]. | |||
==Trichilemmoma== | ==Trichilemmoma== | ||
*May be spelled ''tricholemmoma''. | *May be spelled ''tricholemmoma''. | ||
{{Main|Trichilemmoma}} | |||
==Poroma== | |||
{{Main|Poroma}} | |||
== | ==Nodular hidradenoma== | ||
*[[AKA]] ''eccrine acrospiroma''.<ref name=pmid18319032>{{Cite journal | last1 = Punia | first1 = RP. | last2 = Garg | first2 = S. | last3 = Bal | first3 = A. | last4 = Mohan | first4 = H. | title = Pigmented nodular hidradenoma masquerading as nodular malignant melanoma. | journal = Dermatol Online J | volume = 14 | issue = 1 | pages = 15 | month = | year = 2008 | doi = | PMID = 18319032 |URL = http://dermatology.cdlib.org/141/case_presentations/hidradenoma/punia.html }}</ref> | |||
{{Main|Nodular hidradenoma}} | |||
==Trichoblastoma== | |||
{{Main|Trichoblastoma}} | |||
==Trichofolliculoma== | |||
{{Main|Trichofolliculoma}} | |||
== | ==Apocrine carcinoma of the skin== | ||
===General=== | ===General=== | ||
* | *Rare.<ref name=pmid7678545>{{Cite journal | last1 = Paties | first1 = C. | last2 = Taccagni | first2 = GL. | last3 = Papotti | first3 = M. | last4 = Valente | first4 = G. | last5 = Zangrandi | first5 = A. | last6 = Aloi | first6 = F. | title = Apocrine carcinoma of the skin. A clinicopathologic, immunocytochemical, and ultrastructural study. | journal = Cancer | volume = 71 | issue = 2 | pages = 375-81 | month = Jan | year = 1993 | doi = | PMID = 7678545 }}</ref> | ||
* | *Usually very good prognosis.<ref name=pmid7678545/> | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref | Features:<ref name=pmid7678545/> | ||
* | *Nests. | ||
*Apocrine snouts - "decapitation secretion" | |||
* | |||
DDx: | |||
* | *[[Paget disease of the breast]]/[[Extramammary Paget disease]]. | ||
====Images==== | |||
* | <gallery> | ||
* | Image:Apocrine_carcinoma_-_intermed_mag.jpg | Apocrine carcinoma - intermed. mag. (WC/Nephron) | ||
Image:Apocrine_carcinoma_-_high_mag.jpg | Apocrine carcinoma - high mag. (WC/Nephron) | |||
</gallery> | |||
===Stains=== | |||
Features:<ref name=pmid7678545/> | |||
*PAS +ve. | |||
*PASD +ve. | |||
===IHC=== | |||
*[ | *[[GCDFP-15]] (gross cystic disease fluid protein-15) +ve.<ref name=pmid7678545/> | ||
== | ==Dermatomyofibroma== | ||
:Should ''not'' be confused with [[dermatofibroma]]. | |||
*Abbreviated ''DMF''. | |||
===General=== | ===General=== | ||
* | *Uncommon. | ||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref name= | Features:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref> | ||
* | *Poorly formed fasicles parallel to the skin surface, usu. restricted to the superficial dermis. | ||
*Moderate cellular density - less cellular than [[DFSP]]. | |||
*Eosinophilic cytoplasm. | |||
* | |||
* | |||
DDx: | DDx: | ||
*[[ | *[[DFSP]]. | ||
*[[Dermatofibroma]]. | |||
Images: | |||
*[http://www.dermpedia.org/node/8822 DMF - low mag. (dermpedia.org)]. | |||
*[http://www.dermpedia.org/node/8824 DMF - high mag. (dermpedia.org)]. | |||
===IHC=== | ===IHC=== | ||
Features:<ref name= | Features:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref> | ||
* | *CD10 +ve. | ||
*Vimentin +ve. | |||
* | |||
Others:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref> | |||
*CD34 -ve. | |||
*Factor XIIIa -ve. | |||
*S-100 -ve. | |||
==Papillary eccrine adenoma== | |||
*Abbreviated ''[[PEA]]''. | |||
===General=== | ===General=== | ||
* | *Uncommon. | ||
* | *Benign.<ref name=pmid857729>{{Cite journal | last1 = Rulon | first1 = DB. | last2 = Helwig | first2 = EB. | title = Papillary eccrine adenoma. | journal = Arch Dermatol | volume = 113 | issue = 5 | pages = 596-8 | month = May | year = 1977 | doi = | PMID = 857729 }}</ref> | ||
Treatment: | |||
*Excision.<ref>URL: [http://archderm.jamanetwork.com/article.aspx?articleid=541159 http://archderm.jamanetwork.com/article.aspx?articleid=541159]. Accessed on: 10 December 2012.</ref> | |||
===Gross=== | |||
*Central location. | |||
Note: | |||
*The ''digital papillary adenoma'' is considered malignant; the AFIP says these are best classified as ''adenocarcinomas'', i.e. ''[[digital papillary adenocarcinoma]]''.<ref name=pmid10843279>{{Cite journal | last1 = Duke | first1 = WH. | last2 = Sherrod | first2 = TT. | last3 = Lupton | first3 = GP. | title = Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). | journal = Am J Surg Pathol | volume = 24 | issue = 6 | pages = 775-84 | month = Jun | year = 2000 | doi = | PMID = 10843279 }}</ref> | |||
===Microscopic=== | ===Microscopic=== | ||
Features:<ref> | Features:<ref name=pmid17642667>{{Cite journal | last1 = Laxmisha | first1 = C. | last2 = Thappa | first2 = DM. | last3 = Jayanthi | first3 = S. | title = Papillary eccrine adenoma. | journal = Indian J Dermatol Venereol Leprol | volume = 70 | issue = 6 | pages = 370-2 | month = | year = | doi = | PMID = 17642667 | URL = http://www.ijdvl.com/article.asp?issn=0378-6323;year=2004;volume=70;issue=6;spage=370;epage=372;aulast=Laxmisha }}</ref><ref name=pmid9793207/> | ||
*Well-circumscribed | *Well-circumscribed lesions consisting of multiple cystic spaces lined by a bilayered epithelium with: | ||
* | **Papillary projections into the lumen. | ||
**Amorphous eosinophilic material in the cystic spaces. | |||
**Surrounded by a fibrous stroma.<ref name=pmid9508346>{{Cite journal | last1 = Mizuoka | first1 = H. | last2 = Senzaki | first2 = H. | last3 = Shikata | first3 = N. | last4 = Uemura | first4 = Y. | last5 = Tsubura | first5 = A. | title = Papillary eccrine adenoma: immunohistochemical study and literature review. | journal = J Cutan Pathol | volume = 25 | issue = 1 | pages = 59-64 | month = Jan | year = 1998 | doi = | PMID = 9508346 }}</ref> | |||
Note: | |||
* | *May appear to have more than two cell layers. | ||
DDx: | DDx: | ||
*[[ | *[[Digital papillary adenocarcinoma]] - location important. | ||
*[[ | *[[Tubular apocrine adenoma]] (tubulopapillary hidradenoma<ref name=pmid1566975>{{Cite journal | last1 = Fox | first1 = SB. | last2 = Cotton | first2 = DW. | title = Tubular apocrine adenoma and papillary eccrine adenoma. Entities or unity? | journal = Am J Dermatopathol | volume = 14 | issue = 2 | pages = 149-54 | month = Apr | year = 1992 | doi = | PMID = 1566975 }}</ref>) - a related tumour.<ref name=pmid8238787>{{Cite journal | last1 = Ishiko | first1 = A. | last2 = Shimizu | first2 = H. | last3 = Inamoto | first3 = N. | last4 = Nakmura | first4 = K. | title = Is tubular apocrine adenoma a distinct clinical entity? | journal = Am J Dermatopathol | volume = 15 | issue = 5 | pages = 482-7 | month = Oct | year = 1993 | doi = | PMID = 8238787 }}</ref> | ||
Image: | |||
*[http://www.ijdvl.com/viewimage.asp?img=ijdvl_2004_70_6_370_13482_2.jpg PEA - crappy image (ijdvl.com)].<ref name=pmid17642667/> | |||
== | ===IHC=== | ||
= | Outer layer of epithelium:<ref name=pmid9508346/> | ||
*SMA-alpha +ve. | |||
* | *Keratin 14 +ve. | ||
Inner layer of epithelium:<ref name=pmid9508346/> | |||
*Keratin 8 +ve. | |||
=== | Other stains:<ref name=pmid9793207>{{Cite journal | last1 = Guccion | first1 = JG. | last2 = Patterson | first2 = RH. | last3 = Nayar | first3 = R. | last4 = Saini | first4 = NB. | title = Papillary eccrine adenoma: an ultrastructural and immunohistochemical study. | journal = Ultrastruct Pathol | volume = 22 | issue = 3 | pages = 263-9 | month = | year = | doi = | PMID = 9793207 }}</ref> | ||
*Vimentin +ve. | |||
* | *CEA +ve. | ||
* | *[[EMA]] +ve. | ||
*S-100 +ve. | |||
===Sign out=== | |||
<pre> | |||
SKIN LESION, LEFT PARIETAL SCALP, BIOPSY: | |||
- PAPILLARY ECCRINE ADENOMA. | |||
</pre> | |||
====Micro==== | |||
The sections show a well-circumscribed multi-locular superficial dermal lesion with a bilayered epithelium and intracystic papillary projections. The cystic spaces contain amorphous eosinophilic material. The cystic component is surrounded by a dense fibrous stroma with a mixed inflammatory infiltrate, consisting primary of plasma cells and lymphocytes. | |||
There is no significant nuclear atypia and no mitotic activity is appreciated. The overlying epidermis matures appropriately. A granular layer is present. | |||
=See also= | =See also= |
Revision as of 04:04, 6 June 2018
This article deals with dermatologic neoplasms, also known as skin tumours. It includes dermatologic cancer, which can be deadly. Collectively, dermatologic cancers are the most common form of cancer.
An introduction to dermatopathy is found in the dermatopathology article. Non-malignant disease is covered in the non-malignant skin disease article.
The Big Three malignant
Basal cell carcinoma
Squamous cell carcinoma of the skin
- Abbreviated skin SCC, SCC of the skin, and SCC of skin.
Melanoma
- Known as the great mimicker in pathology; it may look like many things.
Less common malignant
Dermatofibrosarcoma protuberans
- Abbreviated DFSP.
Cutaneous B-cell lymphoma
- Abbreviated CBCL.
General
- CBCL is less common than cutaneous T-cell lymphoma (CTCL).[1]
Microscopic
Features:
- Dermal lymphoid infiltrate.
- "Grenz zone" - space between the epidermis and the dermal infiltrate - key feature.
IHC
- B cell and T cell markers.
Cutaneous T-cell lymphoma
- Abbreviated CTCL.
Merkel cell carcinoma
Eccrine carcinoma
General
- Arises from the proximal sweat duct.
Microscopic
Features:
- Pleomorphic nuclei with nucleoli.
- Duct-like structures - key feature.
- Extends from dermis into epidermis (follows path of a benign sweat duct).
Notes:
- May resemble Extramammary Paget's disease/Paget's disease of the breast.
Kaposi sarcoma
- See Kaposi sarcoma.
Sebaceous carcinoma
Microcystic adnexal carcinoma
Trichilemmal carcinoma
Lymphomatoid papulosis
General
- Rare.
- Benign behaviour.
Microscopic
Features:
- Dermal lymphocytosis.
- No epidermal lymphocytes.
- Focal nuclear atypia.
DDx:
IHC
- CD30 +ve.[2]
Rare malignant
Basosquamous carcinoma
- Should not be confused with basaloid squamous cell carcinoma (AKA squamous cell carcinoma, basaloid variant).
General
- Very rare.
- Largest case series, as of 2000, 35 cases.[3]
- May be considered an aggressive variant of basal cell carcinoma.[3]
- Aggressive behaviour.[4]
Microscopic
Features:
- Has features of both basal cell carcinoma and squamous cell carcinoma.[4]
- BCC component usually predominant.[5]
Note:
- Busam notes that there is disagreement about what defines this tumour;[6] however, he goes on the describe it as a collision tumour.[5]
DDx:
- Basaloid squamous cell carcinoma.
- Basal cell carcinoma with squamous differentiation.
Intermediate
Atypical fibroxanthoma
- Abbreviated AFX.
Benign
Syringoma
General
Microscopic
Features:[8]
- Proliferation of benign ducts with lined by a bilayer (as in normal sweat ducts) with abnormal architecture:
- Tadpole like appearing ducts.
DDx:
- Syringomatous adenomas of nipple (AKA syringoma of the nipple).[9]
- Chondroid syringoma. (???)
Images:
Chondroid syringoma
- Used to be called mixed tumour of skin.[11]
General
- Mixed apocrine & eccrine tumour of skin, usually in the head & neck[11], especially nose and cheek.[12]
- May be in major and minor salivary glands.[12]
Microscopic
Features:
- Mix tumour with:[11]
- Epithelial component:
- Nests of cells with:
- Moderate dull eosinophilic cytoplasm.
- Round/ovoid nuclei with nucleoli.
- Nests of cells with:
- Mesenchymal component - key feature:
- Epithelial component:
Images:
Dermal cylindroma
Keratoacanthoma
Sebaceous adenoma
General
- Seen in Muir-Torre syndrome - a variant of Lynch syndrome (hereditary non-polyposis colon cancer).
Notes:
- Sebaceous lesions (from benign to malignant): sebaceous hyperplasia, sebaceous adenoma, sebaceoma, sebaceous carcinoma.
Microscopic
Features:
- Abnormal sebaceous glands (pale fluffy cytoplasm):
- Increased basal epithelium.
- Multiple dilated glands - opening to the surface.
Images
www:
Trichilemmoma
- May be spelled tricholemmoma.
Poroma
Nodular hidradenoma
Trichoblastoma
Trichofolliculoma
Apocrine carcinoma of the skin
General
Microscopic
Features:[14]
- Nests.
- Apocrine snouts - "decapitation secretion"
DDx:
Images
Stains
Features:[14]
- PAS +ve.
- PASD +ve.
IHC
Dermatomyofibroma
- Should not be confused with dermatofibroma.
- Abbreviated DMF.
General
- Uncommon.
Microscopic
Features:[15]
- Poorly formed fasicles parallel to the skin surface, usu. restricted to the superficial dermis.
- Moderate cellular density - less cellular than DFSP.
- Eosinophilic cytoplasm.
DDx:
Images:
IHC
Features:[15]
- CD10 +ve.
- Vimentin +ve.
Others:[15]
- CD34 -ve.
- Factor XIIIa -ve.
- S-100 -ve.
Papillary eccrine adenoma
- Abbreviated PEA.
General
- Uncommon.
- Benign.[16]
Treatment:
- Excision.[17]
Gross
- Central location.
Note:
- The digital papillary adenoma is considered malignant; the AFIP says these are best classified as adenocarcinomas, i.e. digital papillary adenocarcinoma.[18]
Microscopic
- Well-circumscribed lesions consisting of multiple cystic spaces lined by a bilayered epithelium with:
- Papillary projections into the lumen.
- Amorphous eosinophilic material in the cystic spaces.
- Surrounded by a fibrous stroma.[21]
Note:
- May appear to have more than two cell layers.
DDx:
- Digital papillary adenocarcinoma - location important.
- Tubular apocrine adenoma (tubulopapillary hidradenoma[22]) - a related tumour.[23]
Image:
IHC
Outer layer of epithelium:[21]
- SMA-alpha +ve.
- Keratin 14 +ve.
Inner layer of epithelium:[21]
- Keratin 8 +ve.
Other stains:[20]
- Vimentin +ve.
- CEA +ve.
- EMA +ve.
- S-100 +ve.
Sign out
SKIN LESION, LEFT PARIETAL SCALP, BIOPSY: - PAPILLARY ECCRINE ADENOMA.
Micro
The sections show a well-circumscribed multi-locular superficial dermal lesion with a bilayered epithelium and intracystic papillary projections. The cystic spaces contain amorphous eosinophilic material. The cystic component is surrounded by a dense fibrous stroma with a mixed inflammatory infiltrate, consisting primary of plasma cells and lymphocytes.
There is no significant nuclear atypia and no mitotic activity is appreciated. The overlying epidermis matures appropriately. A granular layer is present.
See also
References
- ↑ URL: http://emedicine.medscape.com/article/1099540-overview. Accessed on: 24 August 2010.
- ↑ URL: http://path.upmc.edu/cases/case513/dx.html. Accessed on: 25 January 2012.
- ↑ 3.0 3.1 Martin, RC.; Edwards, MJ.; Cawte, TG.; Sewell, CL.; McMasters, KM. (Mar 2000). "Basosquamous carcinoma: analysis of prognostic factors influencing recurrence.". Cancer 88 (6): 1365-9. PMID 10717618.
- ↑ 4.0 4.1 Bowman, PH.; Ratz, JL.; Knoepp, TG.; Barnes, CJ.; Finley, EM. (Aug 2003). "Basosquamous carcinoma.". Dermatol Surg 29 (8): 830-2; discussion 833. PMID 12859383..
- ↑ 5.0 5.1 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 397. ISBN 978-0443066542.
- ↑ Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 372. ISBN 978-0443066542.
- ↑ Kumar, Vinay; Abbas, Abul K.; Fausto, Nelson; Aster, Jon (2009). Robbins and Cotran pathologic basis of disease (8th ed.). Elsevier Saunders. pp. 1177. ISBN 978-1416031215.
- ↑ URL: http://emedicine.medscape.com/article/1059871-diagnosis. Accessed on: 12 May 2010.
- ↑ Boecker, W.; Junkers, T.; Reusch, M.; Buerger, H.; Korsching, E.; Metze, D.; Decker, T.; Loening, T. et al. (2012). "Origin and differentiation of breast nipple syringoma.". Sci Rep 2: 226. doi:10.1038/srep00226. PMID 22355740.
- ↑ Nosrati, N.; Coleman, NM.; Hsu, S. (2008). "Axillary syringomas.". Dermatol Online J 14 (4): 13. PMID 18627735.
- ↑ 11.0 11.1 11.2 Kumar, B. (Jan 2010). "Chondroid syringoma diagnosed by fine needle aspiration cytology.". Diagn Cytopathol 38 (1): 38-40. doi:10.1002/dc.21159. PMID 19693940.
- ↑ 12.0 12.1 Rauso, R.; Santagata, M.; Tartaro, G.; Filipi, M.; Colella, G.. "Chondroid syringoma: a rare tumor of orofacial region.". Minerva Stomatol 58 (7-8): 383-8. PMID 19633639.
- ↑ Punia, RP.; Garg, S.; Bal, A.; Mohan, H. (2008). "Pigmented nodular hidradenoma masquerading as nodular malignant melanoma.". Dermatol Online J 14 (1): 15. PMID 18319032.
- ↑ 14.0 14.1 14.2 14.3 14.4 Paties, C.; Taccagni, GL.; Papotti, M.; Valente, G.; Zangrandi, A.; Aloi, F. (Jan 1993). "Apocrine carcinoma of the skin. A clinicopathologic, immunocytochemical, and ultrastructural study.". Cancer 71 (2): 375-81. PMID 7678545.
- ↑ 15.0 15.1 15.2 Busam, Klaus J. (2009). Dermatopathology: A Volume in the Foundations in Diagnostic Pathology Series (1st ed.). Saunders. pp. 504. ISBN 978-0443066542.
- ↑ Rulon, DB.; Helwig, EB. (May 1977). "Papillary eccrine adenoma.". Arch Dermatol 113 (5): 596-8. PMID 857729.
- ↑ URL: http://archderm.jamanetwork.com/article.aspx?articleid=541159. Accessed on: 10 December 2012.
- ↑ Duke, WH.; Sherrod, TT.; Lupton, GP. (Jun 2000). "Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited).". Am J Surg Pathol 24 (6): 775-84. PMID 10843279.
- ↑ 19.0 19.1 Laxmisha, C.; Thappa, DM.; Jayanthi, S.. "Papillary eccrine adenoma.". Indian J Dermatol Venereol Leprol 70 (6): 370-2. PMID 17642667.
- ↑ 20.0 20.1 Guccion, JG.; Patterson, RH.; Nayar, R.; Saini, NB.. "Papillary eccrine adenoma: an ultrastructural and immunohistochemical study.". Ultrastruct Pathol 22 (3): 263-9. PMID 9793207.
- ↑ 21.0 21.1 21.2 Mizuoka, H.; Senzaki, H.; Shikata, N.; Uemura, Y.; Tsubura, A. (Jan 1998). "Papillary eccrine adenoma: immunohistochemical study and literature review.". J Cutan Pathol 25 (1): 59-64. PMID 9508346.
- ↑ Fox, SB.; Cotton, DW. (Apr 1992). "Tubular apocrine adenoma and papillary eccrine adenoma. Entities or unity?". Am J Dermatopathol 14 (2): 149-54. PMID 1566975.
- ↑ Ishiko, A.; Shimizu, H.; Inamoto, N.; Nakmura, K. (Oct 1993). "Is tubular apocrine adenoma a distinct clinical entity?". Am J Dermatopathol 15 (5): 482-7. PMID 8238787.