Congenital cutaneous lymphadenoma

Cutaneous lymphadenoma is an uncommon benign neoplasm often considered to be an adamantinoid variant of trichoblastoma. Lesions present in both sexes, between 14 and 87 years of age, and are mainly located on the head and neck. Cases in children are rare and there is only 1 previous case of a congenital lymphadenoma. An 8‐year‐old Asian girl presented with a congenital lesion on her forehead comprising 4 pink papules, the largest 5 mm in diameter. Microscopy revealed a well‐circumscribed tumor within the dermis and subcutis comprising well‐demarcated epithelial lobules of basaloid and clear cells with subtle peripheral palisading, growing in a collagenous stroma but lacking retraction artefact. A relatively dense accompanying predominantly lymphocytic inflammatory cell infiltrate including both T‐cells (CD3+) and B‐cells (CD20+) permeated the nodules and spilled into the stroma. CD68+ histiocytes and CD1a+ Langerhans cells were moderately numerous. This is the second case of congenital lymphadenoma which—in spite of its rarity in childhood—widens the diagnostic possibilities of cutaneous lymphoepithelial tumors in children.     

Cutaneous lymphadenoma: report of 2 cases.

Cutaneous lymphadenoma is a recently described tumor with a distinctive histological picture associating a basaloid epithelial proliferation and intraepithelial lymphocytes; it seems to represent a benign adnexal neoplasm of uncertain histogenesis. We documented 2 additional examples of cutaneous lymphadenoma with typical histological features; the contiguity of some tumor lobules with preexisting follicular structures was noted. In 1 case, a cutaneous osteoma was present below the tumor. On immunostainings, S-100 protein revealed numerous dendritic intraepithelial and stromal cells. The basaloid proliferation was positive for broad-spectrum keratin antibodies, but negative for KL1 antibody. In addition, several areas were positive for involucrin within tumor lobules. Our findings are consistent with a pilosebaceous origin of cutaneous lymphadenoma.     

Clear cell carcinoma of the skin: a tricholemmal carcinoma?

We report the light and electron microscopic findings of an unusual, locally aggressive cutaneous clear cell carcinoma involving extensively the left cheek and upper lip of a 61-year-old woman. The patient remained free of recurrence 5 years after wide local excision. Microscopically, the tumor was a poorly circumscribed and deeply invasive clear cell neoplasm characterized by large lobules and convoluted trabeculae of polygonal and columnar cells with palisading of the peripheral cells rimmed by thick basement membranes, and horn microcysts with tricholemmal keratinization. The tumor infiltrated the muscle and the salivary glands. Only slight cytologic atypia and a few mitotic figures were present. No definite ductal differentiation was found. Immunoperoxidase staining for carcinoembryonic and epithelial membrane antigens was negative. Ultrastructurally, the tumor cells were joined by desmosomes, and surrounded by thick basal lamina. The cytoplasm contained large pools of glycogen. Peculiar whorls of tonofilaments and aggregates of needle-shaped and club-shaped structures were observed in a small keratinizing focus. The tumor showed features resembling the outer root sheath of the hair follicle microscopically. Furthermore, the lack of duct-like structures and immunoreactivity of carcinoembryonic antigen tend to favor tricholemmal over sweat gland differentiation in this tumor which possibly represents a rare example of tricholemmal carcinoma.     

Glandular congenital lymphadenoma

Abstract:  Cutaneous lymphadenoma is known to occur over a broad age range, from 14 to 72 years of age. We report the unique clinical and histologic presentation of a cutaneous lymphadenoma from the suprapubic abdomen of a neonate which may represent a novel subtype, glandular congenital lymphadenoma. Cutaneous lymphadenoma is a rare tumor with a distinct histologic triad of epithelial nodules, dense fibrous stroma, and intense intranodular lymphocytic infiltrate. Typically, it is a slow growing, skin colored papule, nodule, or plaque, clinically resembling a basal cell carcinoma and often occurring in the head and neck region or lower extremities.     

色素性基底细胞癌

报告1例色素性基底细胞癌。患者女,68岁。右侧腋下黑色条状斑块10余年。皮肤科检查:右侧腋下约3.0 cm×0.2 cm大黑色斑块,边界尚清,其上散在分布数个米粒大黑色丘疹,斑块中部可见糜烂、渗液,渗液周边可见炎症性红斑,无触痛。皮损组织病理检查:表皮层局灶瘤细胞巢,表皮至真皮层可见一肿块,由嗜碱性基底样细胞组成,可见细胞异形性及有丝分裂象,在肿块周边细胞呈栅栏状排列,可见收缩间隙。诊断:色素性基底细胞癌。     

Cutaneous lymphadenoma: a case report and review of the literature

We report a case of cutaneous lymphadenoma, a tumour first described by Santa Cruz and Barr under the name of‘lymphoepithelial tumour1. Twenty-three cases have been reported to date. The commonest site is the head and neck, and it is most commonly diagnosed in the fourth and fifth decades. The usual clinical diagnosis is basal ceil carcinoma. To date, no recurrences have been observed after iocai excision. The tumour is C(miposed of dermal lobules with a biphasic pattern of epithelial and lymphoid cells. It has been suggested that it arises as a result of faulty interaction between lymphocytes and epithelial cells.     

Cutaneous lymphadenoma

Cutaneous lymphadenoma is a rare tumor with distinctive histologic features. This entity was originally described as lymphoepithelial tumor by Santa Cruz and Barr in 1987. It was renamed cutaneous lymphadenoma in 1991. To date, at least 31 cases of this entity have been reported. The literature did not contain a clinical photograph of this lesion. A case of this rare tumor is described that includes clinical and histologic features. The literature regarding the unclear histogenesis of this distinctive tumor is reviewed. This report is one of a only few clinical illustrations of cutaneous lymphadenoma. Consistent with previous reports, the histologic findings in this case include basaloid proliferation and intraepithelial lymphocytes. The usual initial clinical diagnosis is basal cell carcinoma localized mainly to the head and neck area. The incidence is approximately equal in male and female patients. Excision of this benign neoplasm is curative. Controversy exists regarding the histogenesis of this tumor.     

Immunohistochemical comparison of cutaneous lymphadenoma, trichoblastoma, and basal cell carcinoma: support for classification of lymphadenoma as a variant of trichoblastoma

Cutaneous lymphadenoma is an uncommon basaloid epithelial tumor of uncertain histogenesis, most recently classified as a variant of trichoblastoma. Because characteristic immunohistochemical findings have been reported in trichoblastomas, we evaluated the staining patterns of five cutaneous lymphadenomas and compared the results to those of ten trichoblastomas and ten nodular basal cell carcinomas (BCCs), using antibodies to cytokeratin 20 (CK20), bcl-2, and CD34. In addition, because lymphadenomas contain intraepithelial S100-positive putative Langerhans cells, we compared staining of all tumor groups for S100 protein and CD1a. We also attempted to corroborate recent reports of CD30-positive activated lymphocytes in lymphadenomas. We identified CK20-positive Merkel cells in 3/5 lymphadenomas, 7/10 trichoblastomas, and none of the BCCs. Staining for bcl-2 accentuated the peripheral epithelial layer in all lymphadenomas and in 3/10 trichoblastomas, while the remaining trichoblastomas and all BCCs stained diffusely. There was stromal staining with CD34 in two lymphadenoma, 4 trichoblastomas, and 3 BCCs. All lymphadenomas featured numerous intraepithelial S100-positive cells which were also positive for CD1a in three cases tested. In addition, 8/10 trichoblastomas and 2/10 BCCs contained modest numbers of cells labelling for S100 and CD1a. Two of three lymphadenomas contained rare single cells resembling histiocytes faintly positive for CD30, and similar cells labelled for CD68. We conclude that the similar staining patterns of lymphadenomas and trichoblastomas support the classification of lymphadenoma as a variant of trichoblastoma. Staining with CD34 does not reliably distinguish between these tumors and BCCs. Lymphadenomas, trichoblastomas, and BCCs may all contain Langerhans' cells. The relationship between these cells and the striking lymphoid infiltrates seen in lymphadenomas is not clear. In our cases, the CD30-positive cells in lymphadenomas appear to represent histiocytes rather than activated lymphocytes.     

An unusual ostensible example of intraoral basal cell carcinoma

An example of oral basal cell carcinoma is presented originating on the posterior mandibular mucosa and gingiva of a 67-year-old female. Histologically, it featured a multifocal pattern. It recurred eight times in a period of 20 years. Tissue samples of the tumor were evaluated with monoclonal antibody Ber-EP4 and were compared with examples of oral mucosa, skin, oral and cutaneous squamous cell carcinoma, peripheral ameloblastoma, ameloblastoma and cutaneous basal cell carcinoma (BCC). Only neoplastic basal cells showed positive immunohistochemical staining. Additionally, microdissected neoplastic areas were evaluated for loss of heterozygosity (LOH) of the PTCH gene with markers D9S303, D9S252 and D9S287. PTCH gene mutations are reported in patients with Gorlin syndrome and sporadic cutaneous BCCs. Loss of one allele was observed with all three markers. Examples of conventional ameloblastomas did not show evidence of LOH. These observations support the inclusion of BCC in the differential diagnosis of appropriate oral mucosal neoplasms.     

Cutaneous lymphadenoma with ductal differentiation

Cutaneous lymphadenoma (CL) is a recently described neoplasm of unknown histogenesis. Histologically, these tumors typically present as well-circumscribed nodules with scant or no epidermal connections. They are composed of multiple rounded lobules of basaloid cells with some degree of peripheral palisading. These epithelial lobules characteristically show a dense lymphoid infiltrate within them. In cases of CL previously described, there was no obvious adnexal differentiation except for isolated cells showing apparent sebaceous differentiation or hints of follicular differentiation. We report two typical cases of CL that were studied histologically and immunohistochemically. In some of the tumor lobules, there were foci of ductal differentiation, with luminal positivity for CEA and EMA. We postulate that some CL represent a form of immature sweat gland tumor with ductal differentiation.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

Benign lymphoepithelial tumor of the skin ("cutaneous lymphadenoma")

"Benign lymphoepithelial tumor of the skin" or "cutaneous lymphadenoma" is a distinctive benign adnexal tumor presenting a characteristic combination of lobules of epithelial basaloid cells with a peculiar histopathological pattern and a dense intraepithelial T-cell lymphoid and histiocytic population. We report an additional example of this peculiar neoplasm. In addition to the characteristic histopathological features, focal areas showing unequivocal follicular differentiation were observed at the periphery of the tumor. In agreement with other authors we consider that this neoplasm should be included within the spectrum of neoplasms of pilosebaceous origin. Nevertheless, we consider that the original and simple concept of "benign lymphoepithelial tumor of the skin" seems more suitable and illustrative than the more widely used term of "cutaneous lymphadenoma" to define this rare benign adnexal neoplasm.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大。组织病理：真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润。免疫组化：淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100＋和CD1a＋树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达。根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞。     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.     

皮肤淋巴腺瘤二例组织学及免疫组化研究

2例均为发生于面部的单发结节,光滑,粉红色,缓慢增大.组织病理:真皮中不规则的上皮细胞小叶,边缘由基底样细胞呈栅栏状排列,团块中心由透明细胞构成,小叶中及间质中可见大量的小淋巴细胞浸润.免疫组化:淋巴细胞以CD3阳性为主,少量的CD20阳性细胞,上皮团块及周围间质中较多的S-100+CD1a+树突细胞,细胞角蛋白7、细胞角蛋白20、癌胚抗原均为阴性,1例团块中央少量细胞上皮膜抗原和CD30表达.根据组织病理和免疫组化结果,明确为皮肤淋巴腺瘤,其主要的浸润细胞是CD3阳性淋巴细胞.