1/7. Complex adnexal tumor of the primary epithelial germ with distinct patterns of superficial epithelioma with sebaceous differentiation, immature trichoepithelioma, and apocrine adenocarcinoma.A 60-year-old man came for treatment of a sharply outlined erythematous plaque on the gluteal area (45 x 20 mm) of 20 years' duration. Eccentrically located on the plaque was a nodule, 20 mm in diameter. Histological study of the plaque showed a superficial platelike tumor with basaloid bland cytology and sebaceous gland differentiation. Histologic study of the nodule found an undifferentiated adenocarcinoma whose ductlike glandular structures opened to the skin surface and infiltrated the whole depth of the dermis. Study of other areas of the lesion detected two more neoplasms. A nodule of squamous cell carcinoma was found within the superficial band of the benign sebaceous tumor. The fourth neoplastic pattern consisted of epithelial islands composed of basaloid cells within a fibroblastic stroma. There was prominent palisading of epithelial cell nuclei at the periphery of the islands, which usually were surrounded by a sheath of mesenchymal cells. In this complex adnexal tumor of the primary epithelial germ, sebaceous and follicular differentiation both simulate neoplastic patterns recently described as separate entities: superficial epithelioma with sebaceous differentiation and immature trichoepithelioma. The undifferentiated adenocarcinoma may represent differentiation toward the third component of the germ, that is, the apocrine gland.- - - - - - - - - - ranking = 1keywords = island (Clic here for more details about this article) |
2/7. Sclerosing-sweat-duct (microcystic adnexal) carcinoma--a tumor from a single eccrine origin.A patient with a sclerosing-sweat-duct carcinoma of the upper lip is reported. Histologically the tumour showed solid islands and strands of squamous cells and sparse small ductal structures, some of them containing central cores of dense eosinophilic keratin. All this was embedded in a sclerotic stroma. These features, in addition to positive immunoreactivity for carcinoembryonic antigen (CEA) in the lumina of small ducts, and the presence of S-100 protein-positive cells in some cords and ducts, are consistent with the notion that this tumour exhibits differentiation toward eccrine sweat structures.- - - - - - - - - - ranking = 0.5keywords = island (Clic here for more details about this article) |
3/7. Squamous syringometaplasia in lobular panniculitis and pyoderma gangrenosum.Squamous metaplasia of eccrine sweat glands has been most frequently described in chronic cutaneous ulcerations with associated epidermal hyperplasia. We found examples of the process in skin biopsy specimens from five patients: three had associated lobular panniculitis and two had lesions of pyoderma gangrenosum. The metaplasia was located in the mid-to-deep reticular dermis in all five patients and extended into the superficial subcutis in one. Immunohistochemical stains for CEA and S-100 protein were used to accentuate the relationship of the metaplastic islands with eccrine ducts. It is postulated that necrosis of a portion of the eccrine duct is the stimulus for this process.- - - - - - - - - - ranking = 0.5keywords = island (Clic here for more details about this article) |
4/7. Syringomatous adenocarcinoma of minor salivary glands.An intraoral adenocarcinoma showing syringomatous features is reported in a woman aged 71. The tumor, which appeared to arise in minor salivary glands, ulcerated the overlying epithelium. Histologically, it was composed of dilated ductal structures and, in deeper parts, of tumor nests, elongated cords and small ducts containing small lumina. In wide areas, neoplastic ducts were lined by flattened cells, resembling syringoma of the skin. Other ductal structures were lined by atypical columnar or squamous epithelium. Solid squamous islands and superficial small horny cysts were also observed. salivary glands tumors with syringomatous features have rarely been reported. They probably represent a rare variant of salivary adenocarcinoma.- - - - - - - - - - ranking = 0.5keywords = island (Clic here for more details about this article) |
5/7. Hemifacial mixed appendageal tumor in an infant.We believe this to be the first report of a unilateral mixed appendageal tumor without comedones on the face of an infant. Histologically, the tumor had eccrine, apocrine, and basaloid features. The tumor lobules closely resembled islands of basal cell carcinoma. After reviewing the literature, we speculate that some previous case reports of unilateral basal cell nevus were actually appendageal tumors with basaloid differentiation and not true basal cell carcinomas.- - - - - - - - - - ranking = 0.5keywords = island (Clic here for more details about this article) |
6/7. Histologic spectrum of carcinomas with eccrine ductal differentiation (sweat-gland ductal carcinomas).Seven cases of sweat-gland carcinomas showing eccrine ductal differentiation (ductal carcinomas) are presented. The tumors had a variable histological appearance, but were basically characterized by the following histological elements: (a) tubular structures, sometimes cystic or having a "tadpole" appearance; (b) solid islands of squamous, basaloid, or clear cells; (c) periodic acid-Schiff-positive endoluminal and/or intracellular material; and (d) infiltrating growth. Immunocytochemically, tumor cells were positive for keratin and negative for actin. Endoluminal material contained carcinoembryonic antigen in five of seven cases. Although it is not yet clear whether carcinomas exhibiting eccrine ductal differentiation may represent a specific histotype or a group encompassing several distinct clinicopathological entities, the histological analysis of the cases suggested that the wide spectrum of their histological appearances may be due to variable grades of differentiation.- - - - - - - - - - ranking = 0.5keywords = island (Clic here for more details about this article) |
7/7. Reconstruction of nasal tip defects by dorsonasal V-Y advancement island flap.The nasalis musculocutaneous sliding flap developed by Rybka and the myocutaneous axial flap with lateral pedicle reported by Martire and associates are extremely useful for reconstruction of the nasal tip and surrounding area, respectively. We have modified the method of Martire and associates into an operative procedure that can be easily employed. By confirming the blood flow of the lateral nasal artery preoperatively by Doppler probing, the lateral pedicle of the flap was made smaller to facilitate mobilization of the flap. Furthermore, this flap could be made into a reversed-flow flap when indicated.- - - - - - - - - - ranking = 2keywords = island (Clic here for more details about this article) |