Syringoma

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

Path Quiz Case- 32

Dr Sampurna Roy MD

Case history and images:

Site created by

Dr Sampurna Roy MD

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

January 2008

Sebaceous tumours
Fordyce's Spots

Steatocystoma

Nevus Sebaceous

Folliculosebaceous Cystic Hamartoma

Sebaceous Hyperplasia

Sebaceoma

Sebaceous Adenoma

Sebaceous Carcinoma

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

Chondroid Syringoma (benign mixed tumour)

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringofibroadenoma

Malignant sweat gland tumour

Low grade:

Microcystic adnexal carcinoma

Eccrine epithelioma

Adenoid cystic carcinoma

Mucinous carcinoma

Primary extramammary Paget’s disease

Intermediate grade:

Porocarcinoma

Digital papillary adenocarcinoma

High grade:

Hidradenocarcinoma

Apocrine adenocarcinoma

Eccrine ductal carcinoma

Spiradenocarcinoma

Malignant cylindroma

Cutaneous infection and infestations

Histopathological patterns in cutaneous infections

: Bacterial, Rickettsial and Chlamydial infection

: Spirochetal Infection

: Mycoses and algal infections

: Protozoal Infections

: Helminth Infections

: Viral Infections

Cutaneous lesion associated
with AIDS

Lichen planus-like lesions

Lichen Nitidus

Granulomatous Reaction Pattern of the Skin

Granuloma Annulare

Necrobiosis Lipoidica

Necrobiotic Xanthogranuloma

Rheumatoid Nodule

Syringoma is a benign adnexal tumour. These lesions are common in patients with Down syndrome.
Clear cell syringoma are commonly associated with diabetes mellitus.

Clinical presentation:

i) Multiple papules on the lower eyelids and cheeks of adolescent females ii) Solitary & giant lesions, plaque form or milia-like lesions limited to the vulva, penis, buttock , neck , scalp, axilla, abdomen or extremities.

Microscopic features: Image Link1 ; Image Link2 ; Image Link3 ; Image Link4 ; Image Link5.

Dermal tumours are composed of small ducts lined by two layers of cuboidal epithelium ; ducts have a comma-like tail ; 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.

Immunohistochemistry:

Tumour cells express cytokeratin10 in the intermediate cells, cytokeratin 6 and 19 and CEA in the luminal cells and EMA in the peripheral cells of the duct. ( D/D- 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.