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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.
 
=The Big Three malignant=
==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}}
 
==Melanoma==
{{Main|Malignant melanoma}}
*Known as the great mimicker in pathology; it may look like many things.
 
=Less common malignant=
==Dermatofibrosarcoma protuberans==
*Abbreviated ''DFSP''.
{{Main|Dermatofibrosarcoma protuberans}}
 
==Cutaneous B-cell lymphoma==
*Abbreviated CBCL.


==Squamous cell carcinoma==
{{Main|Squamous carcinoma}}
===General===
===General===
Precursor:<ref>TN07 D6.</ref>  
*CBCL is less common than cutaneous T-cell lymphoma (CTCL).<ref>URL: [http://emedicine.medscape.com/article/1099540-overview http://emedicine.medscape.com/article/1099540-overview]. Accessed on: 24 August 2010.</ref>
*Actinic keratosis (solar keratosis).
**Clinical: yellow-brown scaly, patches, sandpaper sensation.


Notes:
*Keratocathoma - see ''[[non-malignant skin disease]]''.
**Some don't believe this entity exists.
***These people sign this entity as ''low grade squamous cell carcinoma, keratoacanthoma type''.<ref>RS. 17 May 2010.</ref>
===Microscopic===
===Microscopic===
*See ''[[squamous cell carcinoma]]''.
Features:
*Dermal lymphoid infiltrate.
*"Grenz zone" - space between the epidermis and the dermal infiltrate - '''key feature'''.


==Basal cell carcinoma==
===IHC===
===General===
*B cell and T cell markers.
*Very common.
 
*Sun exposed skin.
==Cutaneous T-cell lymphoma==
*Very rarely metastasizes - so rare... some don't think this is really a malignancy.
*Abbreviated CTCL.
{{Main|Cutaneous T-cell lymphoma}}


===Clinical===
==Merkel cell carcinoma==
*Telangiectasias.
{{Main|Merkel cell carcinoma}}
*Raised pearly nodule.


====As part of a syndrome====
==Eccrine carcinoma==
*[[Nevoid basal cell carcinoma syndrome]] (NBCCS), AKA ''Gorlin syndrome''.
===General===
*Bazex syndrome (X-linked).<ref>URL: [http://emedicine.medscape.com/article/1101146-diagnosis http://emedicine.medscape.com/article/1101146-diagnosis]. Accessed on: 6 May 2010.</ref>
*Arises from the proximal sweat duct.


===Microscopic===
===Microscopic===
Features:<ref>NEED REF.</ref>
Features:
*Artefactual separation of basal cell layer from underlying stroma.
*Pleomorphic nuclei with nucleoli.
*Palisading hyperchromatic cells.
*Duct-like structures - '''key feature'''.
*Extends from dermis into epidermis (follows path of a benign sweat duct).


Notes:
Notes:
*There are various subtypes: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970110-3 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970110-3].
*May resemble [[Extramammary Paget's disease]]/[[Paget's disease of the breast]].
 
==Kaposi sarcoma==
:See ''[[Kaposi sarcoma]]''.


DDx:
==Sebaceous carcinoma==
*Trichoepithelioma.
{{Main|Sebaceous carcinoma}}
 
==Microcystic adnexal carcinoma==
{{Main|Microcystic adnexal carcinoma}}
 
==Trichilemmal carcinoma==
{{Main|Trichilemmal carcinoma}}


==Melanoma==
==Lymphomatoid papulosis==
===General===
===General===
*[[AKA]] ''Malignant melanoma''.
*Rare.
*Main DDx: [[melanocytic lesions]] - especially if pigmented.
*Benign behaviour.
*Known as the great mimicker in pathology; it may look like many things.
 
====Clinical====
*''ABCD'' = asymmetric, borders (irregular), colour (black), diameter (large).


===Microscopic===
===Microscopic===
Features:
Features:
*Classic appearance of melanoma:
*Dermal lymphocytosis.
**Loosely cohesive; mix of small nests of cells, single cells.
**No epidermal lymphocytes.
**Mixed of spindle and ovoid cell morphology.
*Focal nuclear atypia.
**+/-Occasional large binucleated cells.
**Cytoplasm: brown pigment (melanin).
**Prominent (large) red nucleoli (like in ''serous carcinoma'' of the ovary).
**Marked nuclear pleomorphism - variation in cell size, shape & staining (like in ''serous carcinoma'' of the ovary).
**[[Nuclear pseudoinclusions]] (like in ''papillary thyroid carcinoma'').


Notes:
DDx:
*Can look almost like anything.
*[[CTCL]].
**Like it is said that [[sarcoidosis]] is in every internal medicine DDx... melanoma is every pathologic DDx.
*Cutaneous [[ALCL]].
*Melanomas with:
**An epitheloid cell morphology may mimic adenocarcinoma.
**A spindle cell morphology may mimic spindle cell carcinoma (squamous cell carcinoma) or a sarcoma.


===[[Electron microscopy]]===
===IHC===
*Melanosomes.
*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>


Image(s):
=Rare malignant=
*[http://www.nature.com/nrm/journal/v8/n10/fig_tab/nrm2258_F1.html Melanosomes (nature.com)].
==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.<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>
*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>


===Stains===
===Microscopic===
*''Fontana-Masson stain'', stains melanin.<ref>URL: [http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm http://education.vetmed.vt.edu/curriculum/VM8054/labs/Lab2/Examples/exfontana.htm]. Accessed on: 5 May 2010.</ref>
Features:
**May be useful to differentiate melanin from other brown stuff (e.g. lipofuscin, hemosiderin).
*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>


===[[IHC]]===
Note:
Standard panel:
*''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>
*S-100 +ve.
*HMB-45 +ve.
*Melan A (MART-1) +ve.


Others:
DDx:
*SOX10 +ve -- useful for diff. from excision scar.<ref name=pmid20653825>{{cite journal |author=Ramos-Herberth FI, Karamchandani J, Kim J, Dadras SS |title=SOX10 immunostaining distinguishes desmoplastic melanoma from excision scar |journal=J. Cutan. Pathol. |volume=37 |issue=9 |pages=944–52 |year=2010 |month=September |pmid=20653825 |doi=10.1111/j.1600-0560.2010.01568.x |url=}}</ref>
*Basaloid [[squamous cell carcinoma]].
**SOX-10 = pan-schwannian and melanocytic marker.
*[[Basal cell carcinoma]] with squamous differentiation.


Notes:
=Intermediate=
*The standard panel above (S-100, HMB-45, MART-1) is also positive in other lesions, e.g. ''cellular blue nevus''.
==Atypical fibroxanthoma==
*Abbreviated ''AFX''.
{{Main|Atypical fibroxanthoma}}


==Dermatofibrosarcoma protuberans==
=Benign=
==Syringoma==
===General===
===General===
*Abbreviated ''DFSP''.
*Benign sweat duct tumour.
*Dermal location.
*Eccrine differentiation.
*Destroys adnexal structures.
*Usually close to lower [[eyelid]].<ref>{{Ref PBoD8|1177}}</ref>
 
===Microscopic===
Features:<ref>URL: [http://emedicine.medscape.com/article/1059871-diagnosis http://emedicine.medscape.com/article/1059871-diagnosis]. Accessed on: 12 May 2010.</ref>
*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).<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:
*[http://www.flickr.com/photos/euthman/2329061316/ Syringoma (flickr.com)].
*[http://dermatology.cdlib.org/144/tumors/axillary_syringoma/2.jpg Syringoma (dermatology.cdlib.org)].<ref>{{Cite journal  | last1 = Nosrati | first1 = N. | last2 = Coleman | first2 = NM. | last3 = Hsu | first3 = S. | title = Axillary syringomas. | journal = Dermatol Online J | volume = 14 | issue = 4 | pages = 13 | month =  | year = 2008 | doi =  | PMID = 18627735 |URL = http://dermatology.cdlib.org/144/tumors/axillary_syringoma/hsu.html}}</ref>


Treatment
==Chondroid syringoma==
*Wide excision.
*Used to be called ''mixed tumour of skin''.<ref name=pmid19693940>{{Cite journal  | last1 = Kumar | first1 = B. | title = Chondroid syringoma diagnosed by fine needle aspiration cytology. | journal = Diagn Cytopathol | volume = 38 | issue = 1 | pages = 38-40 | month = Jan | year = 2010 | doi = 10.1002/dc.21159 | PMID = 19693940 }}</ref>


===Histology===
===General===
*Spindle cell morphology.
*Mixed apocrine & eccrine tumour of skin, usually in the head & neck<ref name=pmid19693940/>, especially nose and cheek.<ref name=pmid19633639/>
*Contains adipose tissue within the tumour -- ''key feature''.
*May be in major and minor salivary glands.<ref name=pmid19633639>{{Cite journal  | last1 = Rauso | first1 = R. | last2 = Santagata | first2 = M. | last3 = Tartaro | first3 = G. | last4 = Filipi | first4 = M. | last5 = Colella | first5 = G. | title = Chondroid syringoma: a rare tumor of orofacial region. | journal = Minerva Stomatol | volume = 58 | issue = 7-8 | pages = 383-8 | month =  | year =  | doi =  | PMID = 19633639 }}</ref>


===IHC===
===Microscopic===
Panel:<ref>AP. May 2009.</ref>
Features:
*CD34 +ve.
*Mix tumour with:<ref name=pmid19693940/>
**Usually negative in dermatofibroma.<ref name=pmid7694515>PMID 7694515.</ref><ref name=pmid9129699>PMID 9129699.</ref>
*#Epithelial component:
*Factor XIIIa -ve.
*#*Nests of cells with:
**Usually positive in dermatofibroma.<ref name=pmid7694515>PMID 7694515.</ref><ref name=pmid9129699>PMID 9129699.</ref>
*#**Moderate dull eosinophilic cytoplasm.
*S100 -ve (screen for melanoma).
*#**Round/ovoid nuclei with nucleoli.
*caldesmin -ve (screen for muscle differentiation).
*#Mesenchymal component - '''key feature''':
*beta-catenin ???.
*#*[[Chondromyxoid stroma]].
*MIB-1 (proliferation marker) -- should not be confused with ''MIB1'' a gene that regulates [[apoptosis]].


===DDx - histologic===
Images:
*Dermatofibroma - has entrapment of collagen bundles at the edge of the lesion.
*[https://www.dermnetnz.org/topics/apocrine-mixed-tumour-pathology Chondroid syringoma  (DermnetNZ)].


==Dermal cylindroma==
{{Main|Dermal cylindroma}}


==Cutaneous B-cell lymphoma==
==Keratoacanthoma==
*Abbreviated CBCL.
{{Main|Keratoacanthoma}}


==Sebaceous adenoma==
===General===
===General===
*CBCL is less common than cutaneous T-cell lymphoma (CTCL).<ref>URL: [http://emedicine.medscape.com/article/1099540-overview http://emedicine.medscape.com/article/1099540-overview]. Accessed on: 24 August 2010.</ref>
*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===
Features:
Features:
*Dermal lymphoid infiltrate.
*Abnormal sebaceous glands (pale fluffy cytoplasm):
*"Grenz zone" - space between the epidermis and the dermal infiltrate - '''key feature'''.
**Increased basal epithelium.
**Multiple dilated glands - opening to the surface.
 
====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==
*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}}


===IHC===
==Trichoblastoma==
*B cell and T cell markers.
{{Main|Trichoblastoma}}


==Cutaneous T-cell lymphoma==
==Trichofolliculoma==
*Abbreviated CTCL.
{{Main|Trichofolliculoma}}


==Apocrine carcinoma of the skin==
===General===
===General===
*''Mycosis fungoides'' - is a subtype (???).
*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>
*CTCL is more common than cutaneous B-cell lymphoma (CBCL).<ref>URL: [http://emedicine.medscape.com/article/1099540-overview http://emedicine.medscape.com/article/1099540-overview]. Accessed on: 24 August 2010.</ref><ref>URL: [http://emedicine.medscape.com/article/1098342-overview http://emedicine.medscape.com/article/1098342-overview]. Accessed on: 24 August 2010.</ref>
*Usually very good prognosis.<ref name=pmid7678545/>


===Microscopic===
===Microscopic===
*Atypical lymphocytes:
Features:<ref name=pmid7678545/>
**Have folded "cerebriform" nuclei; ''Sezary-Lutzner cells''.<ref name=Ref_Klatt385>{{Ref Klatt|385}}</ref>
*Nests.
*Grouping:
*Apocrine snouts - "decapitation secretion"
**Nests in the epidermis - known as "Pautrier microabscesses".
 
**Single lymphocytes in epidermis; "lymphocyte exocytosis".<ref>URL: [http://www.mdconsult.com/das/book/body/199872830-2/0/1709/I4-u1.0-B978-0-443-06694-8..50117-2--f2.fig http://www.mdconsult.com/das/book/body/199872830-2/0/1709/I4-u1.0-B978-0-443-06694-8..50117-2--f2.fig]. Accessed on: 6 May 2010.</ref>
DDx:
**Short linear arrays of lymphocytes along the basal layer of the epidermis; "epidermotropism".<ref name=Ref_Klatt385>{{Ref Klatt|385}}</ref>
*[[Paget disease of the breast]]/[[Extramammary Paget disease]].


Images:
====Images====
*[http://www.jci.org/articles/view/24826/figure/2 CTCL (jci.org)].
<gallery>
*[http://www.mdconsult.com/das/book/body/199872830-2/0/1709/I4-u1.0-B978-0-443-06694-8..50117-2--f2.fig CTCL (mdconsult.com)].
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.


==Merkel cell carcinoma==
===IHC===
*[[GCDFP-15]] (gross cystic disease fluid protein-15) +ve.<ref name=pmid7678545/>
 
==Dermatomyofibroma==
:Should ''not'' be confused with [[dermatofibroma]].
*Abbreviated ''DMF''.
===General===
===General===
Features:<ref name=pmid20418670>{{Cite journal  | last1 = Calder | first1 = KB. | last2 = Smoller | first2 = BR. | title = New insights into merkel cell carcinoma. | journal = Adv Anat Pathol | volume = 17 | issue = 3 | pages = 155-61 | month = May | year = 2010 | doi = 10.1097/PAP.0b013e3181d97836 | PMID = 20418670 }}</ref>
*Uncommon.
*Rare.
*Aggressive course/poor prognosis.
*Neuroendocrine-like.<ref name=pmid19395876>{{Cite journal  | last1 = Pulitzer | first1 = MP. | last2 = Amin | first2 = BD. | last3 = Busam | first3 = KJ. | title = Merkel cell carcinoma: review. | journal = Adv Anat Pathol | volume = 16 | issue = 3 | pages = 135-44 | month = May | year = 2009 | doi = 10.1097/PAP.0b013e3181a12f5a | PMID = 19395876 }}
</ref>


Etiology:
===Microscopic===
*Polyomavirus (?).<ref name=pmid20418670/>
Features:<ref name=Ref_Derm504>{{Ref Derm|504}}</ref>
*Immunocompromised/immunosuppressed (e.g. organ transplant recipients).
*Poorly formed fasicles parallel to the skin surface, usu. restricted to the superficial dermis.
*Moderate cellular density - less cellular than [[DFSP]].
*Eosinophilic cytoplasm.


===Microscopic===
DDx:
Features:<ref name=Ref_WMSP491>{{Ref WMSP|491}}</ref>
*[[DFSP]].
*Nests or sheets or trabeculae.
*[[Dermatofibroma]].
*Scant cytoplasm.
*Nuclear moulding.
*Multiple small nucleoli.
*Usually mitotically active.


Image:
Images:
*[http://www.ispub.com/ispub/ijd/volume_5_number_2_8/concurrent_merkel_cell_carcinoma_and_bowen_s_disease_of_the_thigh/bowen-fig3.jpg Merkel cell carcinoma (ispub.com)].
*[http://www.dermpedia.org/node/8822 DMF - low mag. (dermpedia.org)].
*[http://commons.wikimedia.org/wiki/File:Merkelcellcarcinoma_Tag.jpg Merkel cell carcinoma - nested pattern (WC)].
*[http://www.dermpedia.org/node/8824 DMF - high mag. (dermpedia.org)].


===IHC===
===IHC===
*CK7 -ve, CK20 +ve
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.


==Eccrine carcinoma==
==Papillary eccrine adenoma==
*Abbreviated ''[[PEA]]''.
===General===
===General===
*Arises from the proximal sweat duct.
*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:
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/>
*Pleomorphic nuclei with nucleoli.
*Well-circumscribed lesions consisting of multiple cystic spaces lined by a bilayered epithelium with:
*Duct-like structures - '''key feature'''.
**Papillary projections into the lumen.
*Extends from dermis into epidermis (follows path of a benign sweat duct).
**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>
Image: [http://commons.wikimedia.org/wiki/File:Eccrine_carcinoma_intermed_mag.jpg Eccrine carcinoma - intermed. mag. (WC)].
 
Note:
*May appear to have more than two cell layers.
 
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.


==Eccrine poroma==
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>
===General===
*Vimentin +ve.
*Benign tumour arising from the distal sweat duct.
*CEA +ve.
*Erythematous - gross.
*[[EMA]] +ve.
*S-100 +ve.


===Microscopic===
===Sign out===
Features:<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70190-5 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675(06)70190-5]. Accessed on: 2 July 2010.</ref>
<pre>
*Broad sheets of basaloid cells containing ductal structures - '''key feature'''.
SKIN LESION, LEFT PARIETAL SCALP, BIOPSY:
*Biphasic stroma:
- PAPILLARY ECCRINE ADENOMA.
*#Edematous stroma.
</pre>
*#Sclerotic stroma.
*Moderate nuclear pleomorphism.
*+/-Occasional mitoses.


Notes:
====Micro====
*Area above gland appears crusted.
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.


==Kaposi sarcoma==
There is no significant nuclear atypia and no mitotic activity is appreciated. The overlying epidermis matures appropriately. A granular layer is present.
:See ''[[Kaposi sarcoma]]''.


==See also==
=See also=
*[[Dermatopathology]].
*[[Dermatopathology]].
*[[Cytopathology]].
*[[Cytopathology]].


==References==
=References=
{{reflist|2}}
{{reflist|2}}


[[Category:Dermatopathology]]
[[Category:Dermatopathology]]
Michael
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