Pathology of Papillary Eccrine Adenoma

Dr Sampurna Roy MD             2022      

Papillary eccrine adenoma, a rare benign adnexal tumour, was first described in 1977. Papillary eccrine adenoma. Arch Dermatol. 1977;113(5):596-8.

Clinical presentation:  Firm or hard nodules, frequently of many years' duration, and a large proportion are situated on the extremities.

 

Microscopic features: Well circumscribed lesion ; Tumour is composed of dilated duct-like structures of various sizes with intraluminal papillary projections ; Ducts are lined by two or more layers of cells ; Inner layer often forms one or multiple papillae of variable complexity ; Lumina contains eosinophilic amorphous material ; Fibrous stroma around the lesion is well separated from the surrounding dermis  ; Stroma consists of patches of loosely arranged spindled cells and areas of hyalinized collagen. Other features -  focal squamous differentiation ; clear cell change ; connection of ducts to the epidermis ; prominent nerves within the stroma. 'Tubulopapillary hidradenoma' is a term proposed to describe lesions with both eccrine and apocrine differentiation. It encompasses a spectrum of lesions that includes tubular apocrine adenoma and papillary eccrine adenoma. Immunohistochemistry:   Demonstrated immunoreactivity to S-100 protein, carcinoembryonic antigen, and epithelial membrane antigen.

Differential diagnosis: The differential diagnosis includes other cutaneous neoplasms with intraductal papillary proliferation.

Dermatopathology Quiz Case 131