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 Dr Sampurna Roy MD

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

Cysts:

Hydrocystoma -Eccrine/Apocrine

Hamartomas:

Eccrine/Apocrine naevus

Eccrine Angiomatous Hamartoma

Porokeratotic eccrine ostial naevus

Benign Neoplasms:

Syringocystadenoma Papilliferum

Hidradenoma Papilliferum

Nipple Adenoma

Syringoma

Spiradenoma

Cylindroma

Chondroid Syringoma (benign mixed tumour)

Poroma

Hidradenoma

Apocrine adenoma

Papillary eccrine adenoma

Syringofibroadenoma

Lichen planus-like lesions

Bullous Pemphigoid

Hailey-Hailey Disease 

Granuloma Annulare

Necrobiosis Lipoidica

Necrobiotic Xanthogranuloma   

Rheumatoid Nodule

Foreign body granuloma

Rosacea

Erythema Nodosum

Role of immunohistochemistry in Dermatopathology 

Cutaneous Pseudolymphoma

Drug related cutaneous lesions

Cutaneous lesion in graft-
versus host disease

A rare type of locally aggressive sweat gland carcinoma which was originally described as a basal cell carcinoma with eccrine differentiation (eccrine epithelioma) by Freeman et al in 1969  . This tumour was later reported as eccrine syringomatous carcinoma by other authors. 
                                  
Tumour presents as a plaque or firm nodule on the scalp, extremities or trunk of middle aged adults.

Aggressive local recurrence is common. Distant metastasis is usually rare.

Microscopic features:

Image1 ;  Image2 ;  Image3  
Infiltrating tumour located in the dermis ; May invade into the subcutaneous fat and muscle ; Composed of solid nests , cords and small tubules lined by basaloid cells ; Tubules may contain PAS positive, diastase resistant, alcian blue positive material ; Some ducts demonstrate tail-like extension resembling syringoma. This feature is also present in microcystic adnexal carcinoma(MAC). ; Clear cell variant has been reported ; Backround stroma is usually desmoplastic in nature ; Perineural invasion is often identified ; Cytological atypia is not prominent ; Mitotic activity is not significant.

Differential diagnosis :  Syringoma, basal cell carcinoma,  microcystic adnexal carcinoma , adenoid cystic carcinoma, metastatic carcinoma. Syringomatous carcinoma is distinguished from MAC on the basis of a lack of follicular (keratocyst, hair germ, matricial) or sebaceous differentiation. According to some authors  Syringomatous carcinoma is part of the spectrum of MAC.    
                                                           

Abstracts:

Skin adnexal neoplasms--part 2: An approach to tumours of cutaneous sweat glands.J Clin Pathol. 2007 Feb;60(2):145-59. Epub 2006 Aug 1.

Sclerosing sweat duct carcinoma of the eyelid. Jpn J Ophthalmol. 2004 ;48(1):7-11.

Syringoid eccrine carcinoma: report of a case with immunohistochemical analysis of cytokeratin expression.Am J Dermatopathol. 2002;24(5):409-13.

Carcinomas of sweat glands: report of 60 cases.Arch Pathol Lab Med. 2001 ;125(4):498-505.

Syringoid eccrine carcinoma.J Eur Acad Dermatol Venereol. 2001 ;15(2):143-6.

Clear cell syringoid carcinoma: an ultrastructural and immunohistochemical study.Am J Dermatopathol. 2000 ;22(1): 60-4.

Sclerosing sweat-duct carcinoma (malignant syringoma) of the upper eyelid: a patient report with immunohistochemical and ultrastructural analysis.Ophthal Plast Reconstr Surg. 1998 ;14(6):441-5.

A case of syringomatous carcinoma derived from the lid.Nippon Ganka Gakkai Zasshi. 1998;102(4):281-6.

Syringomatous carcinoma of the eyelid and orbit: a clinical and histopathological challenge .Br J Ophthalmol. 1997 ;81(8):668-72.

Syringoid eccrine carcinoma: a case report.Am J Dermatopathol. 1997 Oct;19(5):533-5.

Syringoid eccrine carcinoma.J Am Acad Dermatol. 1991;24(5 Pt 2):857-60.

The enigmatic eccrine epithelioma (eccrine syringomatous carcinoma).Am J Dermatopathol. 1990;12(6):552-61.

Syringoid eccrine carcinoma.J Dermatol Surg Oncol. 1987;13 (1 ): 64-7.

Clear cell syringoid eccrine carcinoma.Am J Dermatopathol. 1987 ;9(3):225-31.

Basal cell tumor with eccrine differentiation (eccrine epithelioma).J Cutan Pathol. 1984;11(6):553-7.

Eccrine adenocarcinoma. A clinicopathologic study of 35 cases.Arch Dermatol. 1983;119(2):104-14.

Basal cell tumor with eccrine differentiation (eccrine epithelioma).J Am Acad Dermatol. 1982;6(4 Pt 1):514-8.

Sweat gland carcinoma with syringomatous features: a light microscopic and ultrastructural study.Cancer. 1979;44(1):157-63.

Soft Tissue Pathology; Myxoid Tumours of Soft Tissue ;  Classification of Soft Tissue Tumour;  Gross examination of soft tissue specimen ;  A practical approach to histopathological reporting of soft tissue tumours ;  Grading of soft tissue tumours ; Lipomatous tumours ;Neural tumours ; Myogenic tumours ; Fibroblastic/Myofibroblastic tumours ; Myofibroblastic tumours ;  Fibrohistiocytic tumours ; ChondroOsseous tumours ; Soft TissueTumours of Uncertain Differentiation ; Notochordal Tumour -Chordoma ;Extra-adrenal Paraganglioma ; Gastrointestinal Stromal Tumour ;

Cardiac Path Online; FUNCTIONAL ANATOMY OF THE HEART ; ANATOMY OF THE ATRIUM ;ANATOMY OF THE VENTRICLE ; ANATOMY OF THE CORONARY ARTERIES ; AUTOPSY EXAM. OF CORONARY ARTERIES ; EXAMINATION  OF CARDIAC  VALVES  ; CARDIAC  VALVE  DISEASE ;MITRAL VALVE DISEASE ; PULMONARY VALVE DISEASE ; TRICUSPID VALVE DISEASE ; PROSTHETIC AND BIOPROSTHETIC CARDIAC VALVES  ; CARDIOMYOPATHY ;congenital heart disease ; Ischemic heart disease ; Angina pectoris ;Myocardial infarction ;  hypertensive heart disease; myocardiTIS ; PRIMARY TUMOURS OF THE HEART ; REPORTING OF CARDIAC TUMOURS ; CARDIAC MYXOMA ; CARDIAC RHABDOMYOMA ; PAPILLARY FIBROELASTOMA ; CARDIAC FIBROMA ; CARDIAC LIPOMA ;CARDIAC HEMANGIOMA ; CARDIAC TERATOMA ; MESOTHELIOMA OF ATRIOVENTRICULAR NODE ;PURKINJE CELL TUMOUR ; CARDIAC PARAGANGLIOMA ; MALIGNANT TUMOURS OF THE HEART ; CARDIAC LYMPHOMA ;

Hair Germ Differentiation:

Trichoepithelioma 

Desmoplastic Trichoepithelioma

Trichofolliculoma

Trichoblastoma

Cutaneous lymphadenoma

                               
Infundibular differentiation:

Trichoadenoma

Dilated Pore of Winer

Pilar Sheath Acanthoma

Tumour of Follicular Infundibulum

Outer root sheath differentiation:
                    
Trichilemmoma

Trichilemmal Carcinoma

Proliferating Trichilemmal Cyst (Pilar Tumour)

Matrical differentiation:
                  
Pilomatrixoma and Pilomatrix Carcinoma