Showing most revelant items. Click here or hit Enter for more.
Spiradenoma
Small cells with scant cytoplasm and small hyperchromatic nuclei; typically at periphery of tumor lobules
Larger cells with eosinophilic cytoplasm and oval, vesicular nuclei; typically in centers of tumor lobules
• Focal to diffuse duct lumen formation
• Tumor lobules associated with vascularized stroma, hemorrhage may be present
Top Differential Diagnoses
• Cylindroma
Significant overlap with spiradenoma and may have combined tumors
Cylindroma has jigsaw puzzle pattern
• Spiradenocarcinoma (malignant spiradenoma)
Associated with precursor spiradenoma
• Basal cell carcinoma
Peripheral palisading with tumor-stroma retraction
• Merkel cell carcinoma
More cytologic atypia and high mitotic rate
Positive for CK20 and neuroendocrine markers
Spiradenoma at Low MagnificationLow magnification of a spiradenoma shows a dermal-based tumor characterized by irregularly-shaped nodules and smaller lobules in the dermis.
Spiradenoma With Large Dermal NodulesSpiradenoma is characterized by circumscribed, cellular basophilic nodules or lobules in the dermis. The tumor lobules often have a surrounding fibrous capsule .
Spiradenoma With Edematous StromaThe stroma in this case is edematous and highlights the associated capillary vasculature .
Spiradenoma at High MagnificationThe tumor is composed of a biphasic population of smaller basaloid cells and larger pale cells. Duct lumen formation is present and may be focal or relatively prominent, as in this case.
TERMINOLOGY
Synonyms
• Eccrine spiradenoma
Definitions
• Benign adnexal tumor composed of nodules of basaloid cells with ductal differentiation
• May have apocrine or eccrine differentiation
ETIOLOGY/PATHOGENESIS
Genetic Syndrome
• Familial cases associated with autosomal dominant Brooke-Spiegler syndrome
a.k.a. familial cylindromatosis or turban tumor syndrome
Multiple cylindromas, but can also have spiradenomas and trichoepitheliomas
CLINICAL ISSUES
Epidemiology
• Age
Most common in young adults but can present at any age
Site
• Upper 1/2 of body most commonly involved; > 75% present on ventral surface
Presentation
• Dermal mass/nodular lesion
Often tender or painful, may have bluish color
Usually solitary but may be multiple
– Multiple lesions may be part of Brooke-Spiegler syndrome
– Less frequently, may be associated with trichoblastoma and cutaneous lymphadenoma as part of morphological spectrum of Brooke-Spiegler syndrome
Treatment
• Surgical approaches
Complete surgical excision is curative
Prognosis
• Benign, but local recurrence may occur; very rare malignant transformation
MACROSCOPIC
General Features
• Dermal-based, bluish nodule
Only gold members can continue reading. Log In or Register to continue
Larger cells with eosinophilic cytoplasm and oval, vesicular nuclei; typically in centers of tumor lobules
in the dermis.
.
.
is present and may be focal or relatively prominent, as in this case.
