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Pathology of Syringoma

Dr Sampurna Roy MD   




Syringoma is a benign adnexal tumour originating from the intraepidermal portion of the eccrine duct.

The name syringoma is derived from the Greek word syrinx, which means pipe or tube.

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These lesions are common in patients with Down syndrome.

Clear cell syringoma are commonly associated with diabetes mellitus.

Dermatopathology patterns that remind us of something else

Clinical presentation:

i) Multiple papules on the lower eyelids and cheeks of adolescent females

ii) Solitary and giant lesions, plaque form or milia-like lesions limited to the vulva, penis, buttock, neck, scalp, axilla, abdomen or extremities.

Eruptive syringoma is a rare, clinically distinct variant of syringoma. 

Microscopic features: 

Dermal tumours are composed of small ducts lined by two layers of cuboidal epithelium ;

Ducts have a comma-like tail (tadpole appearance);

Solid nests and strands of basaloid cells may be present in the dermis ;

Some ducts contain eosinophilic material ;

Backround stroma is usually fibrotic ;

The lesion is well demarcated from the surrounding dermis ;

Numerous mast cells are present in the stroma in some cases;

Clear cell variant- ducts are lined by epithelial cells with pale or clear cytoplasm.


Tumour cells express cytokeratin10  in the intermediate cells, cytokeratin 6 and 19 and Carcinoembryonic antigen (CEA) in the luminal cells and epithelial membrane antigen (EMA) in the peripheral cells of the duct.  

(Differential diagnosis - Carcinoembryonic antigen (CEA) is negative in desmoplastic trichoepithelioma ).  

Progesterone receptors are expressed in most syringomas.

Differential diagnosis:   

Microcystic adnexal carcinoma (no perineural invasion or deep extension in syringoma).  It is impossible to make the distinction in a shave biopsy.

Chondroid syringoma.


Further reading:

An unusual presentation and distribution of generalized eruptive syringomas.

Multiple giant vulvar syringoma: an extraordinary report.

Vulvar nonclear cell syringoma associated with pruritus and diabetes mellitus.

Cutaneous syringoma: a clinicopathologic study of 34 new cases and review of the literature.

Penile syringoma: reports and review of patients with syringoma located on the penis.

Linearly distributed syringoma: a case report.

"Eruptive" facial syringomas: an inflammatory skin reaction?





Dr Sampurna Roy  MD

Consultant  Histopathologist (Kolkata - India)






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