Ch. 5 - Sweat gland neoplasms Flashcards
What is “focal decapitation secretion”?
A hallmark of apocrine differentiation in sweat gland tumors
What do “red” and “blue” sweat gland tumors differentiate towards?
Red - Sweat duct
Blue - Secretory component
Cylindroma (turban tumor)
Islands of blue cells in a jigsaw-puzzle pattern outlined by a deeply eosinophilic basement membrane.
Inherited and multiple on the scalp.
Spiradenoma
Very large round islands of blue cells peppered with lymphocytes (tender). Can have eosinophilic hyaline droplets.
Sporadic and solitary.
Recite the mnemonic for tender skin tumors.
BANGLE:
Blue rubber bleb nevus
Angiolipoma
Neuroma (neurilemmoma)
Glomus tumor
Leiomyoma
Eccrine spiradenoma
Spiradenocarcinoma
Atypia, mitoses, and necrosis arising in long-standing spiradenomas.
Syringocystadenoma papilliferum (SPAP)
Papillary lesion open to surface with decapitation secretion and plasma cells.
Can occur within nevus sebaceus.
Hidradenoma papilliferum (HPAP)
Blue papillary dermal nodule with branching cystic spaces and decapitation secretion.
Papillary digital carcinoma
(+epidemiology)
Blue tumor with papillary fronds and cystic changes. Atypia with mitoses and necrosis.
Usually involves the hands of young patients
Mucinous carcinoma
Islands of blue cells in a sea of mucin.
Can be primary in the skin or metastatic from breast or GI tract (looks identical).
Syringoma
(+epidemiology)
Paisley-pattern of ducts with ample pink cytoplasm in a dense sclerotic stroma.
Usually in asian women and children with Down’s syndrome.
Clear cell syringoma
Tadpole-shaped ducts with clear glycogenated cells in a dense sclerotic stroma.
Associated with diabetes mellitus.
Microcystic adnexal carcinoma
Deeply invasive biphasic pattern (sweat duct-like and pilar) with tadpole-shaped ducts and basaloid nests with pilar differentiation. Dense sclerotic stroma and lymphoid aggregates.
Sclerosing weat duct carcinoma
Monophasic variant of MAC with only the tadpole component in a sclerotic stroma with lymphoid aggregates.
Hidrocystoma
Simple cyst lined with cuboidal or columnar cells with decapitation secretion.
Mixed tumor (chondroid syringoma)
Sweat ducts with ample pink cytoplasm embedded in a mesenchymal stroma often with cartilaginous or bone formation.
Small tubular type mixed tumor
Small tubule sweat ucts with ample pink cytoplasm embedded in a mesenchymal stroma often with cartilaginous differentiation.
Branching alveolar type
Sweat ducts with a long, branching and alveolar pattern in a mesenchymal stroma often with cartilaginous differentiation.
Malignant mixed tumor (malignant choroid syringoma)
Sweat ducts with atypia, mitoses, and necrosis embedded in a mesenchymal stroma often with cartilaginous differentiation.
Acrospiroma
Cuboidal pink cells with a tendency towards clear cell degeneration with cuticle lined ducts.
(a large family of sweat gland tumors)
Poroma
Cuboidal cells with ample pink cytoplasm with cuticle-lined ducts. Connects to the epidermis and commonly found on the foot.
Hidroacanthoma simplex
Intraepidermal nests of cuboidal cells with ample pink cytoplasm resembling clonal seborrheic keratosis, but containing ducts.
Dermal duct tumor
Small dermal nodules of cuboidal cells with ample pink cytoplasm and cuticle-lined ducts.
Nodular hidradenoma
Large dermal nodule of cuboidal pink cells and cuticle-lined ducts with bright red zones of basement membrane zone reduplication.
