Skin Appendage Tmour

     

http://www. histopathology-india.net/SwCa.htm

 

                           HISTOPATHOLOGY INDIA.COM

                  Microcystic Adnexal Carcinoma

        Dr  Sampurna Roy  MD

 
        DermPath-India

        Site created by

    Dr Sampurna Roy MD

          

http://www.histopathology-india.net/dermpath.htm

August 2009

Outer root sheath differentiation:
                    
Trichilemmoma

Trichilemmal Carcinoma

Proliferating Trichilemmal Cyst (Pilar Tumour)

Matrical differentiation:
                  
Pilomatrixoma and Pilomatrix Carcinoma

Benign sweat gland tumours

Cysts:

Hydrocystoma -Eccrine/Apocrine

Hamartomas:

Eccrine/Apocrine naevus

Eccrine Angiomatous Hamartoma

Porokeratotic eccrine ostial naevus

Benign Neoplasms:

Syringocystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma

Syringoma

Spiradenoma

Cylindroma

Chondroid Syringoma (benign mixed tumour)

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringofibroadenoma

Malignant sweat gland tumour 

Low grade:

Microcystic adnexal carcinoma

Eccrine epithelioma

Adenoid cystic carcinoma

Mucinous carcinoma

Primary extramammary Paget’s disease

Intermediate grade:

Porocarcinoma

Digital papillary adenocarcinoma

High grade:

Hidradenocarcinoma

Apocrine adenocarcinoma

Eccrine ductal carcinoma

Spiradenocarcinoma

Malignant cylindroma

Sebaceous tumours

Fordyce's Spots

Steatocystoma

Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia

Sebaceoma

Sebaceous Adenoma

Sebaceous Carcinoma

                   

Hidradenocarcinoma is a rare sweat gland tumour.

The tumour range from locally recurring , low grade well differentiated tumour to highly aggressive high grade tumour with potential for local and distant metastasis to lymphnodes, bones and lungs.

Site:  Often located on the face, scalp and extremities as an ulcerated reddish nodules.

Age: In elderly patients and sometimes in children and at birth.

Microscopic features: 

    Case Link1:  Case Link2

Asymmetrical tumour ;  Infiltrative dermal proliferation of variable sized lobules and nests showing cyst formation ; Connection to the epidermis is rare ; Composed of a mixture of eosinophilic polygonal cells, squamous cells, mucinous and clear cells;  Pleomorphism and necrosis is common;  There are ducts and intracytoplasmic lumina; Decapitation secretion is present in some cases ; Glycogen is demonstrated in the cytoplasm of some of the clear cells.

Differential diagnosis:  Clear cell carcinoma of the skin:click

Tumours composed predominantly of clear cells need to be distinguished from metastatic clear cell carcinoma particularly renal cell carcinoma.

              

Abstracts:

Skin adnexal neoplasms--part 2: An approach to tumours of cutaneous sweat glands.J Clin Pathol. 2007 Feb;60(2):145-59. Epub 2006 Aug 1.

Nodular hidradenocarcinoma on the scalp of a young woman: case report and review of literature.Dermatol Surg. 2004 ;30(9) :1265-8.

Malignant eccrine hidradenoma of neck causing acute heart failure.Auris Nasus Larynx. 2003;30(3):307-10.

Nodular hidradenocarcinoma with prominent squamous differentiation: case report and immunohistochemical study.J Cutan Pathol. 2000;27(8):423-7.

Giant hidradenocarcinoma: a report of malignant transformation from nodular hidradenoma.Pathol Int. 1998 ;48(10):818-23.

Metastatic clear cell eccrine hidradenocarcinoma of the vulva: survival after primary surgical resection.Gynecol Oncol. 1996 ;61(2):287-90.

Malignant clear cell hidradenoma of the upper lip.Head Neck. 1994;16(5) :443-9.

Nodular hidradenoma and hidradenocarcinoma. A 10-year review.J Am Acad Dermatol. 1985 ;12(1 Pt 1):15-20.

Vulvar sweat gland carcinomas. Arch Pathol Lab Med. 1985 ;109(1):43-7.

Clear cell hidradenocarcinoma- a case report with unusual in situ malignant changes.J Surg Oncol. 1984;26(1):1-5

                 

 

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Criteria of malignancy :
-Infiltrative growth pattern 
-Prominent cytological atypia. In some cases there is minimal atypia
-High mitotic activity (not reliable criteria)
-Perineural invasion
-Vascular invasion
-Presence of comedonecrosis.
Tumours of the Hair Follicle

Hair Germ Differentiation:

Trichoepithelioma 

Desmoplastic Trichoepithelioma

Trichofolliculoma

Trichoblastoma

Cutaneous lymphadenoma

                          
    
Infundibular differentiation:

Trichoadenoma

Dilated Pore of Winer

Pilar Sheath Acanthoma

Tumour of Follicular Infundibulum

Cutaneous lesion associated  with AIDS

Actinomycosis

Avian Influenza 

Candidosis

Chikungunya

Coccidioidomycosis

Cryptococcosis

Cryptosporidium

Cytomegalovirus infection

Dengue

Dermatophytosis

Giardiasis

Glanders

Granuloma Inguinale 

Haemophilus influenza Infection

Herpes Virus

Herpes Simplex Virus Infection


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