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Pathology of Spiradenoma

Dr Sampurna Roy MD        May  2016

Dermatopathology Quiz Case 186

Diagnosis : Spiradenoma

 

Spiradenoma is a benign dermal 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.

 

Further reading:

Infiltrative Recurrent Eccrine Spiradenoma of the Anterior Neck Treated Using Mohs Micrographic Surgery.

Painful eccrine spiradenoma containing nerve fibers: a case report.

Differential considerations of skin tumours with florid vascularisation: report of a solitary giant vascular eccrine spiradenoma.

Multiple vascular eccrine spiradenomas: a case report and published work review of multiple eccrine spiradenomas.

A case of eccrine spiradenoma in a patient with neurofibromatosis.

Eccrine spiradenoma with chondroid syringoma in Blaschkoid distribution.

An unusual case of congenital linear eccrine spiradenoma.

Eccrine spiradenoma: co-expression of cytokeratin and smooth muscle actin suggesting differentiation toward myoepithelial cells.

Multiple linear spiradenoma with a linear distribution.


 

Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)

 

                                                                                                                                              


 

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