Squamous cell apocrine hidradenoma

Apocrine hidradenoma is a benign adnexal neoplasm with apocrine differentiation. The neoplasm is composed of four different types of epithelial cells, including pale or clear cells, polygonal cells, mucinous cells and squamous cells, with variable proportions of them from case to case. In most examples of this neoplasm, clear or the polygonal cells are predominant, whereas the other types of neoplastic cells are less abundant. We report two cases of apocrine hidradenoma mostly composed of squamous cells. Histopathologic examination showed that the neoplasms were composed of both solid and cystic areas. The solid aggregations of neoplastic cells were composed of a peripheral layer of basaloid polygonal cells, whereas squamous cells forming the bulk of the aggregations. These squamous cells showed large eosinophilic cytoplasm and vesicular nuclei with prominent nucleoli. In one case, small foci of mucinous cells could also be seen in some aggregations of neoplastic cells, mostly around ductal structures. In both the cases, some of the tubular structures lined by epithelial cells showed evidence of decapitation secretion in their luminal border. The neoplastic stroma consisted of sclerotic collagen bundles when compared with adjacent normal dermis, and artefactual clefts separated the neoplasms from the surrounding tissue. The rare cases described in this report are exceptional because most of the neoplastic cells showed squamous appearance and for that reason we think that squamous cell apocrine hidradenoma is the most appropriate name for these neoplasms.     

Pigmented apocrine hamartoma of the vulva: A case report

We herein report a patient who clinically presented with a pigmented, flat plaque in the vulvar area. Histological examination showed a benign lesion mainly composed of tubular and cystic glands with apocrine differentiation. The most striking histological feature was the deposition of finely granular melanin pigment both in the epithelial cells and in the luminal surface of the glands. In addition, Melan‐A immunostaining showed the presence of numerous melanocytes within the lesion suggesting that the pigment deposition was secondary to colonization of the lesion by melanocytes. We therefore diagnosed this lesion as “pigmented apocrine hamartoma.” To the best of our knowledge only 3 cases of pigmented apocrine hamartoma have been reported in the literature so far.     

Pigmented hamartoma of the eyelid with apocrine, follicular and sebaceous differentiation

AIM: Adnexal tumors with divergent lines of differentiation are uncommon. Herein, I report a hamartoma of the eyelid with follicular, sebaceous and apocrine differentiation that exhibited prominent melanin pigmentation. METHODS: A 63-year-old white woman had a nodule present on her left upper eyelid for 15 years. The nodule had been slowly increasing in size but was unchanged in color. Examination disclosed an 8- x 5-mm nodule of the left upper eyelid, with slight purple discoloration. RESULTS: Biopsy showed a well-circumscribed tumor composed of predominantly apocrine glands but with areas of sebaceous and follicular differentiation. Some areas had prominent light-brown, granular pigment within tumor cells. The pigment had histochemical features of neuromelanin. Immunohistochemistry indicated that the hamartomatous elements had antigenic features of various adnexal structures independent of the histological phenotype. The hamartomatous cells did not react with antibodies to tyrosinase or melanoma antigen recognized by T-cells 1 (MART-1). CONCLUSIONS: This case is unique because of its location and prominent melanin pigmentation. Lack of tyrosinase activity in the tumor cells and the periodic acid-Schiff (PAS) positivity of the pigment indicating its similarity to neuromelanin raise the possibility that the melanin in the hamartoma is a non-enzymatically derived oxidation product of a substance intrinsic to the tumor cells.     

Pigmented apocrine hidrocystoma—a report of two cases and review of the literature

Two cases of pigmented apocrine hidrocystoma in two women aged 47 and 60 years are reported. In both patients the lesion was located in the temporal region. Histopathological examination did not show the nature of the pigment present in both lesions. It is suggested that the pigmentation observed clinically is due to the Tyndall phenomenon.     

Poroid hidradenoma

Poroid hidradenoma is a recently described variant of eccrine poroma. This neoplasm presents structural findings of hidradenoma (solid and cystic areas) and cytological characteristics of poromas (poroid and cuticular cells, the latter showing ductal differentiation). We present a case of poroid hidradenoma in a 74-year-old woman, who consulted her physician because of a nodular lesion on the left buttock.     

实性囊性汗腺瘤

<正>患者男,39岁。主诉:左前臂赘生物4年。现病史:患者4年前左前臂出现米粒大淡红色丘疹,逐渐增大至花生米大,颜色变成紫红色,无明显痒痛及破溃。为明确诊断、进一步治疗来本院就诊。既往史:既往体健,否认外伤史,否认系统性疾病史。家族史:家族中无类似疾病患者。体格检查:一般情况好,浅表淋巴结未触及增大,系统检查无异常。     

实性囊性汗腺瘤

<正>患者男,67岁。主诉:左大腿外侧结节1年余。现病史:患者1年前无明显诱因于左大腿外侧出现黄豆大肤色结节,结节颜色逐渐变浅,呈半透明状,无疼痛及瘙痒等症状,1年来结节体积无明显增大。既往史、个人史及家族史:患者患糖尿病17年,高血压病12年;否认有食物、药物过敏史;否认家族遗传病史及类似疾病史。     

Eruptive hidradenoma

This case report emphasizes two clinical findings that aid in the diagnosis of eruptive hidradenoma. They are the predilection of the lesions for the anterior rather than posterior surface of the trunk and the presence of milialike inclusions within the papules. Eruptive hidradenomas are appendageal tumors that differentiate toward intraepidermal eccrine ducts and the milialike papules represent dilated cystic ductal structures. This patient had concomitant involvement of the eyelids, which has been observed in some, but not all, cases of eruptive hidradenoma.     

Poroid hidradenoma

A 36‐year‐old Korean man presented with a nodular lesion on the buttock. It was a walnut‐sized, tender, soft, and movable nodule covered by normal skin which had been enlarging steadily over a period of one year ( Fig. 1 ). Surgical exploration revealed the tumor to be a cyst containing serous, brownish fluid. It was totally excised. Histological examination showed a well‐demarcated, 1.3 × 0.9 cm tumor with cyst formation in the center and surrounded by a zone of connective tissue in the middle and lower dermis, without any connection to the overlying epidermis ( Fig. 2a ). The cystic wall was composed of tumor cells. Variably sized tumor lobules protruded into the cystic space. The tumor nests consisted of two cell types: smaller, darker poroid cells and larger, paler cuticular cells. Mitotic figures were not present. Vacuolar spaces were seen within the cytoplasm of some cuticular cells, which were thought to represent early stages of ductal differentiation. Ductal structures lined by eosinophilic cuticle were present in some tumor lobules ( Fig. 2b ). Peripheral pallisading was occasionally observed, but it was not a prominent feature] the cells at the edges of the lobules tended to be rather flattened. Periodic acid‐Schiff stain with diastase demonstrated variable amounts of glycogen within the cytoplasm of some tumor cells. Carcinoembryonic antigen (CEA) immunostaining was positive in the luminal border of the cystic space, which appeared as a sensitive marker of ductal differentiation. Epithelial membrane antigen also showed a positive reaction in luminal borders of the cystic space. Tumor cells were positive for vimentin, but negative for S‐100 protein] however, many dendritic cells scattered throughout the neoplasm were positive for S‐100 protein.

Figure 1 Open in figure viewer PowerPoint A walnut‐sized, tender, soft, movable nodule covered by normal skin is seen on the buttock.     

Axillary apocrine carcinoma associated with apocrine adenoma and apocrine gland hyperplasia

Apocrine carcinomas represent a rare group of tumors with a potential for destructive local invasion, regional and distant metastases, and are equally common in both sexes. A case of a 79-year-old woman with axillary apocrine carcinoma associated with apocrine adenoma and apocrine gland hyperplasia is presented. To our knowledge, this is the first case diagnosed in a Caucasian and also the first case diagnosed in a female patient. Grossly, the tumor measured 3.2x1.5x1.2 cm and on cut section appeared granular, white to gray-tanned. Microscopically, the tumor was located in the dermis, poorly demarcated, focally necrotic with ulcerated overlying skin. It was predominantly composed of complex, closely packed tubuloglandular structures but in few areas papillary structures were also observed. The cells contained abundant eosinophilic, finely granular cytoplasm with pleomorphic nuclei and showed apocrine-like decapitation. The cytoplasm contained periodic acid Schiff diastase resistant granules. Mitoses were frequent and some were atypical. In one area, the tumor was lobular and composed of tubular structures lined with one layer of uniform cuboidal or columnar eosinophilic cells, indicating a pre-existing apocrine adenoma. Beneath the tumor, in the deep dermis and subcutaneous tissue, hyperplastic apocrine glands were also found. No additional therapy was used, and one year after the surgery the patient was alive and showed no signs of tumor spread. This and previously reported cases suggest that apocrine hyperplasia and apocrine adenoma may represent successive steps in the development of apocrine carcinoma.