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Pathology of Hidradenoma

Dr Sampurna Roy MD  

Pathology Quiz Case 75 : Case history and images

Diagnosis: Poroid Hidradenoma

Pathology Quiz Case 77 : Case history and images:

Diagnosis: Clear Cell Hidradenoma

 
Skin Appendage Tumour

       

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

March 2014
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

Syringo fibroadenoma

Malignant sweat gland tumour 

Low grade:

Microcystic adnexal carcinoma

Eccrine epithelioma

Adenoid cystic carcinoma

Mucinous  carcinoma

Primary extramammary Pagetís disease

Intermediate grade:

Porocarcinoma

Digital papillary adenocarcinoma

High grade:

Hidradeno carcinoma

Apocrine adenocarcinoma

Eccrine ductal carcinoma

Spiradeno carcinoma

Malignant cylindroma

 

Erythema Nodosum

Folliculitis

Impetigo

Furuncle(Boil)

Carbuncle

Toxic Shock Syndrome

Allergic Granulomatosis (Churg-Strauss Syndrome)

Median Raphe Cyst

Cutaneous Ciliated Cyst

Infective Panniculitis

 

Sebaceous tumours

Fordyce's Spots

Steatocystoma

Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia

Sebaceoma

Sebaceous Adenoma

Sebaceous Carcinoma

 

Pathology of the Eyelid

Inflammatory diseases of the Eyelid

Tumour and tumour-like lesions of the Eyelid

Adnexal Tumours of the eyelid

Epidermal tumours of the Eyelid

Syn: Clear cell hidradenoma,  solid and cystic hidradenoma or dermal acrospiromas.

Hidradenoma is a benign dermal appendage tumour.

Hidradenomas may be of eccrine or apocrine origin.

Solitary, nodule often partly solid, partly cystic.

Site:  

Located in any part of the body. There is a slight predilection for the head, face, and upper extremities.

Microscopic features:  

Well-circumscribed dermal tumor with a grenz zone between the tumour and the epidermis ;

Variously shaped tumour islands in the dermis ;

May extend into the subcutis ; 

Combination of solid and cystic areas ;

Cystic spaces form as a result of tumour cell degeneration ;

The intervening stroma varies from delicate vascularized  fibrous tissue to dense hyalinized collagen ;  

Minimal epidermal connection may be present ; 

Foci of squamous differentiation; 

Ductal differentiation and intracytoplasmic lumina ; 

Mitotic figures are often present which is of little prognostic significance.

Two types of cells -  One cell type is polyhedral with a rounded nucleus and slightly basophilic cytoplasm. The second cell type is generally round with clear cytoplasm.

Variants:  Clear cell ; Poroid ; Oncocytic ; Epidermoid, and Pigmented. 

Images of Clear cell Hidradenoma:

  

Images of Poroid Hidradenoma: 

  

Clear cell hidradenomas are characterized by prominent clear cells which is present in less than one third of hidradenomas. Mucus producing cells are found in some cases.  The clear cells contain glycogen and periodic acid-Schiff-positive, diastase-resistant material, but no lipid.

Poroid hidradenomas are well circumscribed , non-encapsulated tumours composed of predominantly poroid cells. 

Cytologically, this variant resembles an eccrine poroma.

Atypical hidradenomas- cytological atypia or infiltrative margins; higher rate of recurrence and malignancy. The significance of atypical nuclear changes in benign eccrine acrospiromas: a clinical and pathological study  of 18 cases.J Cutan Pathol. 1984 Feb;11(1):35-44.

Differential diagnosis:

It is sometimes difficult to distinguish solid cellular hidradenomas without duct-like structures and glomus tumour without a vascular pattern.

Clear cell hidradenoma:    Differential Diagnosis- Clear cell tumours of skin ; Hidradenocarcinoma. (Clear cell hidradenoma: a mimic of metastatic clear cell tumors. Arch Pathol Lab Med. 2005;129(5):e 113-6.)

Nodular hidradenoma can recur after inadequate excision.

                        

Further  reading:

Clear cell hidradenoma

Clear cell hidradenoma: An unusual tumor of the oral cavity

Clear Cell Hidradenoma of the Axilla: a Case Report with Literature Review

Malignant Nodular Hidradenoma of the Eyelid: A Rare Sweat  Gland Tumor

Nodular hidradenoma of male breast: Cytohistological correlation

Giant benign nodular hidradenoma of the shoulder: A rare tumor in orthopedic practice

Tubulopapillary hidradenoma: A rare case with cyto histopathological correlation

Clear cell hidradenoma: a mimic of metastatic clear cell tumors. Arch Pathol Lab Med. 2005;129(5):e 113-6.

Poroid hidradenoma.International Journal of Dermatology Volume 40 Issue 1 Page 62 - January 2001

Poroid hidradenoma. Report of a case with cytologic findings on fine needle aspiration.Acta Cytol1999;43(3):471-4.

Poroid hidradenoma. A case presentation.J Am Podiatr Med Assoc. 1998 Oct;88(10):510-3

Nodular hidradenoma. A report of three cases and review of the literature.Dermatol Surg. 1998;24(3):387-91.

Histogenesis of clear cell hidradenoma: immuno- histochemical study of keratin expression. J Cutan Pathol. 1997;24(1):30-6.

Phenotypic heterogeneity of nodular hidradenoma. Immunohistochemical analysis with emphasis on cytokeratin expression.  Am J Dermatopathol.1996;18(6):592-6.

Oncocytic nodular hidradenoma.Am J Dermatopathol. 1996 ;18(3):314-6.

Fine-needle aspiration of nodular hidradenoma: a case report. Diagn Cytopathol. 1996;15(5):395-7.

A single lesion demonstrating features of eccrine poroma and poroid hidradenoma.J Dermatol. 1995;22(10):773-9.

Poroid hidradenoma: a light microscopic and immunohistochemical study.Cutis. 1992;50(1):43-6.

Immunohistochemistry in the differential diagnosis of nodular hidradenoma and glomus tumor. Am J Dermatopathol. 1992;14(4):310-4.

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

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

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Tumours of the Hair Follicle

Hair Germ Differentiation:

Trichoepithelioma 

Desmoplastic  Trichoepithelioma

Trichofolliculoma

Trichoblastoma

Cutaneous lymphadenoma
                    
Infundibular differentiation:

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Dilated Pore of Winer

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Tumour of Follicular Infundibulum

Outer root sheath differentiation:
                    
Trichilemmoma

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Matrical differentiation:
                  
Pilomatrixoma and Pilomatrix Carcinoma

 

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Granuloma Annulare

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Melkersson Rosenthal Syndrome

AnnularElastolytic Giant Cell Granuloma

Skin lesion in Crohn's Disease

Blastomycosis-like pyoderma

Foreign body granuloma

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