Pathology of Spiradenoma - Dr Sampurna Roy MD

Dermpath-India

Pathology of Spiradenoma

Dr Sampurna Roy MD 2022

Dermatopathology Quiz Case: 220

Answer - Spiradenoma

Dermatopathology Quiz Case: 153

Spiradenoma is a rare benign adnexal tumour occuring in adults.

This lesion often coexists with cylindromas.

Clinical presentation:

Usually presents as a painful or tender solitary nodule (less than 1cm in diameter).

May occasionally present as multiple lesions .

Giant variants, linear or zosteriform distribution have also been reported.

Site: Head and neck, sometimes on the scalp and on the trunk. Rarely on the extremities.

Microscopic features:

Tumour consists of sharply demarcated lobules located in the dermis without connection to the epidermis ;

Eosinophilic PAS positive basement membrane-like material may be present around the lobules ;

Two cell types are present ; Small cells with dark nuclei are present at the periphery and the large paler cells are at the centre ;

Cells are arranged around small lumina ;

Lumina contains small amounts of granular eosinophilic material that is PAS- positive and diastase resistant ;

Numerous small lymphocytes are present throughout the tumour lobules.

Tumour may show prominent degenerative changes, fibrosis and cyst formation ;

Ancient changes (dilated vessels rimmed by sclerosis) ;

Larger tumours are partially or totally necrotic ;

Immunohistochemistry:

Strands of cells are cytokeratin positive and lumina are CEA positive.

Malignant transformation of spiradenoma (Spiradenocarcinoma) may occur in rare cases.

Brooke-Spiegler syndrome is a rare, autosomally dominant disease characterized by the development of multiple cylindromas, trichoepitheliomas, and occasional spiradenomas.

Brooke-Spiegler Syndrome-[Pathology Infographic]

Dermatopathology Quiz Case: 153