1/27. Apocrine acrosyringeal keratosis in association with syringocystoadenoma papilliferum.We report the clinical and histopathological features of a keratosis that developed in association with syringocystadenoma papilliferum. This tumour shows a pinkish, pedunculated, spherical nodule with a cerebriform surface and visible keratinous plugs. In addition to the typical features of syringocystadenoma papilliferum, the tumour shows many hyperkeratotic columns surrounded by acanthotic epidermis with the characteristics of trichilemmal keratinization and keratohyalin granules. This keratosis seems to be derived from the middle to lower portion of the apocrine acrosyringium, based on the distribution of keratohyalin granules and the direct connection with the apocrine acrosyringium in an early lesion. Accordingly, we propose to identify this rare keratosis as apocrine acrosyringeal keratosis.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
2/27. Extramammary Paget disease with underlying hidradenoma papilliferum: guilt by association?Extramammary Paget disease (EMPD) is a heterogenous entity representing either an intraepidermal adenocarcinoma in situ with apocrine differentiation or an expression of underlying malignancy of the skin or of the intestinal or genitourinary tract. The coexistence of EMPD with a benign underlying hidradenoma papilliferumn (HP) is, however, exceptional. We present the case of a 79-year-old woman with diffuse and patchy gray-white lesions involving her left vulva as well as an underlying 0.7-cm asymptomatic firm nodule. Histologically, the epidermis and dermis showed features characteristic of EMPD and HP, respectively. Malignant transformation in HP giving rise to EMPD in the overlying epithelium has been reported. In our case, however, failure to demonstrate continuity between the two lesions together with the lack of cytologic atypia, mitoses, and necrosis in the HP lends additional support to the possibility that the HP is "innocent" and that its association with EMPD is thus coincidental. A common histogenetic derivation of these two lesions from the mammary-like glands or from related germinative cells in the epidermis is suggested to explain this rare presentation.- - - - - - - - - - ranking = 3keywords = dermis (Clic here for more details about this article) |
3/27. An unusual melanocytic lesion associated with eccrine duct fibroadenomatosis and syringoid features.The intimate association of nevomelanocytic nevi with eccrine ducts commonly seen in congenital nevi was emphasized by Mishima, who described as eccrine-centered nevi those lesions characterized by nevomelanocytic cells predominantly proliferating around and within the eccrine sweat duct walls. However, there were no changes in the overlying epidermis, dermis, or eccrine acrosyringeal or dermal duct proliferation in these lesions. We present the case of a 16-year-old boy with a 1-year-history of a 0.6-cm diameter single tan papule on the right heel, clinically thought to be a Spitz nevus. Histopathologic examination revealed a compound nevomelanocytic nevus associated with epidermal hyperplasia, thin anastomosing cords of acrosyringeal epithelium extending within the dermis, and eccrine ductal proliferation in a syringoma-like pattern associated with a dense fibrous stroma. Features that distinguish our case from eccrine-centered nevus are that the latter lacks epidermal and eccrine duct hyperplasia and a dense fibrous stroma. The location of the lesion on the heel in our case suggests the possibility that the pathologic changes observed could result from repetitive trauma.- - - - - - - - - - ranking = 3keywords = dermis (Clic here for more details about this article) |
4/27. Acrosyringeal adenomatosis (eccrine syringofibroadenoma of Mascaro). A case report and review of the literature.The case of a 63-year-old man with acrosyringeal adenomatosis (eccrine syringofibroadenoma of Mascaro) is reported. Asymptomatic papular lesions had appeared on the dorsum of both of his feet 30 years earlier, then extended gradually and symmetrically to his hands, arms, legs, trunk, and auriculae. Although his hair, teeth, and nails were normal, he had glaucoma, chronic sinusitis, chronic otitis media, chronic pancreatitis, and gastrointestinal polyposis. No similar symptoms were found in the family history. Histopathologically, proliferations of pale epithelial cells extended from acrosyringia into the dermis, forming interconnected epithelial cords, within some of which were ductal structures. A syringoma and syringoma-like structures were closely associated with these lesions. Enzyme-histochemical, immunohistochemical, and ultrastructural studies supported the concept that this case represents a benign tumor derived from the acrosyringium, which is different from eccrine poroma. Acrosyringeal adenomatosis seems to be a more appropriate name for such a lesion than does eccrine syringofibroadenoma (Mascaro).- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
5/27. Poroid hidradenoma: a light microscopic and immunohistochemical study.Poroid hidradenoma is a recently described variant of the eccrine poroma group of tumors. This neoplasm shows architectural characteristics of hidradenoma (tumor cells confined entirely within the dermis in both solid and cystic components) and cytologic characteristics of poroid neoplasm (poroid and cuticular cells, the latter showing ductal differentiation). Therefore the term "poroid hidradenoma" seems to be the most appropriate. We document herein a case of poroid hidradenoma studied by immunoperoxidase techniques. Our immunohistochemical results are similar to those of other poroid neoplasms. These also support the inclusion of this tumor as the fourth variant within the eccrine poroma group of tumors.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
6/27. Clear cell hidradenoma: a tumor with basaliomatous changes in the overlying epidermis and follicular infundibula of surrounding skin.We report a clear cell hidradenoma on the cheek of a Japanese man. We performed the primary operation on the flesh-colored tumor, which had surface telangiectasia. The histopathologic features of the tumor, which indicated an intradermal nodular hidradenoma, consisted mainly of typical clear cells with small numbers of eosinophilic fusiform cells. Most clear cells reacted negatively for CEA, EMA, S-100 protein and KL-1 keratin, but those in and around the cystic and ductal structures reacted positively for CEA, EMA and KL-1 keratin. Ultrastructurally, these clear cells had numerous microvillus processes, abundant intracytoplasmic glycogen granules, and numerous mitochondria. In addition, buds of hyperpigmented keratinocytes hung from the overlying epidermis and thin cords of hyperpigmented keratinocytes proliferated around the follicular infundibula beside the tumor. Within two months of the primary operation, growth of the tumor into the overlying epidermis recurred rapidly. We discuss the histological features of the combination of clear cell hidradenoma with basaliomatous changes of the overlying and surrounding skin and the highly aggressive recurrence of this type of tumor after primary treatment.- - - - - - - - - - ranking = 6keywords = dermis (Clic here for more details about this article) |
7/27. Hidradenoma papilliferum with mixed histopathologic features of syringocystadenoma papilliferum and anogenital mammary-like glands.A case of hidradenoma papilliferum with mixed features of syringocystadenoma papilliferum (SCAP) and anogenital mammary-like glands is reported. A single, fresh red-colored nodule developed in the sulcus between the labia majora and minora of a 49-year-old Japanese woman. Histopathologically, the tumor showed epithelial lining with apocrine secretion and slight connective tissues characteristics. Our case was unique because, like SCAP, the tumor was connected to the epidermis and cystic invaginations extended downward into the deep dermis. In addition, beneath the tumor, tubular structures that resembled normal mammary tissue were present in the subcutaneous fatty tissue. In this study, it has been suggested that this tumor might have been developed from these mammary-like glands.- - - - - - - - - - ranking = 2keywords = dermis (Clic here for more details about this article) |
8/27. Syringocystadenoma papilliferum associated with apocrine poroma.A 65-year-old Japanese man presented with a gradually enlarging mass on the right side of the abdomen, which he had first noticed about 4 years previously. He was otherwise asymptomatic. Histopathological examination of the mass revealed an aggregation of neoplastic cells (tumor cell nests) with cellular proliferation extending from the epidermis to the dermis. The tumor consisted of two histologically distinct parts. One part was composed of uniformly small cells with a cuboidal appearance. Some ductal structures were visualized, and some of the cells lining the ductal lumina contained decapitation secretions. These histological changes were consistent with the diagnosis of apocrine poroma. The remaining part of the tumor was composed of cystic invaginations with numerous projections oriented toward the lumen. There were two rows of cells in the projections; the cells on the luminal side were columnar, and those at the apical aspect were small cuboidal cells. These histological changes were characteristic of syringocystadenoma papilliferum (SCAP). Based on these findings, a diagnosis of SCAP associated with apocrine poroma was made. To the best of our knowledge, there have been no previous reports of such a case in the published work.- - - - - - - - - - ranking = 2keywords = dermis (Clic here for more details about this article) |
9/27. Syringocystadenoma papilliferum: a rare breast tumor in a young boy.Syringocystadenoma papilliferum of the breast is extremely rare in children. However, some occasional cases have been diagnosed in females. This report documents a case of syringocystadenoma papilliferum occurring in a healthy 4-year-old male. Histopathologically, this tumor, located deep in the dermis, was characterized by the presence of papillary projections extending into the lumen of epithelial cystic invaginations in a background of dense fibrous tissue. The papillary projections and the duct-like structures were lined by an inner columnar epithelium, which demonstrated luminal apical decapitation secretion, and had an outer layer of smaller cuboidal cells. These findings support apocrine differentiation in this case. A fairly dense mononuclear infiltrate in the stroma of the tumor, especially in the papillary projections, was also present. Although syringocystadenoma papilliferum is rare in children, it should not be summarily ruled out during examinations of masses found in the pediatric male breast. It is important to recognize this unusual location of the tumor so that a prompt diagnosis, based on histopathology and surgical excision, can be proposed.- - - - - - - - - - ranking = 1keywords = dermis (Clic here for more details about this article) |
10/27. Hidradenoma papilliferum of the upper eyelid arising from the apocrine gland of Moll.Hidradenoma papilliferum is derived from apocrine sweat glands and was originally described as a tumor located in the anogenital area. The authors recently examined a 78-year-old man with a hidradenoma papilliferum at the margin of the upper eyelid. While the tumor was located in the dermis, serial sections showed a connection to the epidermis and neoplastic cells partially replacing a gland of Moll. There were glandular structures with luminal cells that showed apical decapitation-type secretion, indicating the apocrine origin of the tumor. The luminal cells also contained granules that stained with periodic acid-Schiff (PAS) stain and were diastase resistant. Results of examination of the duct-forming cells by transmission electron microscopy showed adluminal villi, focal decapitation secretion, luminal cytoplasmic debris, and electron-dense cytoplasmic secretory granules. Because the apocrine glands of Moll are localized adjacent to the eyelid cilia, hidradenoma papilliferum and other tumors of apocrine origin should be considered in the clinical setting of a mass at the eyelid margin.- - - - - - - - - - ranking = 2keywords = dermis (Clic here for more details about this article) |
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