Hidradenoma Papilliferum

 Apocrine differentiation is usually seen


image Often with decapitation secretion


• Outer layer of cuboidal myoepithelial cells

• Variable degree of mitotic index




Top Differential Diagnoses




• Syringocystadenoma papilliferum (SCP)
image Similar histologic features, indicating that these are likely closely related tumors

image Epidermal connections much more common in SCP

• Tubular apocrine adenoma
image Simpler lesions composed predominately of tubular structures

• Nipple adenoma (erosive adenomatosis of nipple, florid papillomatosis)

• Papillary eccrine adenoma

• Hidradenoma

image
Hidradenoma Papilliferum at Low Magnification
Hidradenoma papilliferum (HP) is typically a well-circumscribed, dermal-based tumor. This case shows focal epidermal attachments with erosions image, findings similar to those seen in syringocystadenoma papilliferum. Cystic and branching spaces image can easily be identified on low power.


image
Hidradenoma Papilliferum With Branching Spaces
This area of HP shows the cystic and branching ductal/glandular spaces image, which can usually be easily identified on low power.

image
Hidradenoma Papilliferum at Higher Magnification
Higher magnification of a HP shows the elongated, arborizing papillary structures image lined by 2-3 cell layers of bland columnar luminal cells and underlying myoepithelial cells.

image
Hidradenoma Papilliferum at High Magnification
H&E shows high magnification of a cystic area with evidence of apocrine differentiation. The surface-lining cells show apical snouts and secretions image. Note the lack of cytologic atypia or pleomorphism.


TERMINOLOGY


Abbreviations




• Hidradenoma papilliferum (HP)


Synonyms




• Papillary hidradenoma


Definitions




• Small, well-circumscribed, dermal-based adenoma with apocrine differentiation


CLINICAL ISSUES


Epidemiology




• Incidence
image Rare

• Age
image Adult

• Sex
image Almost always women

• Ethnicity
image No race predilection


Site




• Vulva or perianal region
image Rarely other sites (and termed ectopic HP)

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Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Hidradenoma Papilliferum

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