汗管样小汗腺癌

报告1例汗管样小汗腺癌.患者女,56岁.左外耳部浸润性斑块伴疼痛10年.皮肤科检查见左外耳郭浸润性肤色斑块,总面积达4cm×3cm,中央偏红,表面平滑,无破溃,与皮肤粘连,质硬固定,伴触痛.皮损组织病理检查:真皮中下部及皮下组织间多数基底样瘤细胞团块,瘤细胞形成巢状、条索状或蝌蚪样肿瘤团块,伴有大量管腔及囊腔样结构形成,纤维结缔组织明显增生,与瘤细胞间形成明显的主间质分离.未见角质囊肿及筛状结构形成.免疫组化染色示:上皮膜抗原(EMA)、癌胚抗原(CEA)、细胞角蛋白CAM5.2、细胞角蛋白(CK)7和CK5/6阳性,S-100蛋白阳性,囊泡病液体蛋白(GCDFP)-15、CK20、甲状腺转录因子(TTF)-1均阴性.该病例被诊断为汗管样小汗腺癌.     

Syringoid eccrine carcinoma

A rare case of a syringoid eccrine carcinoma in a 52-year-old male patient is described. During the first hospitalization, syringoma was diagnosed, both clinically and histologically, keeping in mind the possibility of its malignant alteration. Difficulties in making a diagnosis with histological and immunohistochemical examinations are reported. The possibility of differential diagnosis of primary breast carcinoma and methods of its exclusion are also described. Treatment of the patient was surgical with good results.     

Syringoid eccrine carcinoma with apparently aggressive transformation: case report and review of the literature

A 65‐year‐old man presented with a 20‐year history of a lesion on his lower abdomen. The lesion had started as an indolent papule that slowly developed to form an extensive plaque. Physical examination revealed a flat‐topped, elevated, well‐demarcated, erythematous plaque measuring 7 cm × 5 cm in diameter ( Fig. 1 ). The lesion had an elastic, hard induration beneath the plaque and was fixed to the underlying tissue. Inguinal lymphadenopathy was present. Hematologic and biochemical investigations were all within the normal ranges. The patient underwent incision biopsy.

Figure 1 Open in figure viewer PowerPoint Clinical appearance of the lesion. An indurated plaque can be seen on the lower abdomen     

Eccrine syringofibroadenoma: a case report with analysis of cytokeratin expression

A 56-year-old man presented with a 30-year history of a slowly enlarging lesion on the sole of his right foot. A biopsy showed an anastomosing network of small cuboidal cells with the formation of occasional sweat ductal lumina and a marked fibrovascular stroma. The histological findings were interpreted as consistent with the diagnosis of an eccrine syringofibroadenoma. Using immunohistochemistry all the tumour cells were positively stained by the pan-cytokeratin antibody Lu-5 and an antibody to the cytokeratins 1/5/10/11. In addition the luminal ductal cells expressed cytokeratin 19 and CEA. Tumour cells were negative for cytokeratins 1, 7, 8, 13 and 18 and did not express vimentin and GCDFP-15. The results indicate that the eccrine syringofibroadenoma is differentiated towards the dermal eccrine duct.     

Dilated pore: a case report and an immunohistochemical study of cytokeratin expression

We report a 71-year-old Japanese female with a dilated pore in the form of a nodule above her right eyebrow. Histologic examination revealed a flask-shaped, keratinous cystic structure that was continuous with the surface epidermis and had numerous elongated rete ridges in the lower portion. An immunohistochemical study using a panel of monoclonal antibodies against cytokeratins (CKs) and involucrin detected CK1 and CK10 in the suprabasal cells of the cystic structure. CK8 and CK19 expression was observed in the outermost layer of some elongated rete ridges; it was composed of pallisading columnar cells. Most parts of the outermost layer of the cystic structure stained positively with AE1 antibody. From these immunohistochemical findings, we speculated that the dilated pore in our case was an isolated clinical entity is a follicular tumor differentiating mainly toward the infundibulum and partly toward the isthmus.     

Immunohistochemical analysis of cytokeratin expression in reactive eccrine syringofibroadenoma-like lesion: a comparative study with eccrine syringofibroadenoma

In addition to solitary eccrine syringofibroadenoma (ESFA), there is another type of ESFA which is associated with underlying dermatoses (reactive ESFA-like lesion). Five lesions in 4 patients of reactive ESFA-like lesion were analyzed by an immunohistochemical method using 13 kinds of anti-cytokeratin (CK) antibodies. Two cases of solitary ESFA were also studied by the same procedure for comparison. Suprabasal staining pattern of AE1 and MNF116, which stain CKs 6, 16 and 17, markers of hyperproliferative state, was observed diffusely in 5 lesions of reactive ESFA-like lesions except for focal negative staining in one case, and was observed focally in one case of solitary ESFA. Furthermore, differentiation-specific cytokeratin expression was reduced in 3 of 5 lesions of reactive ESFA-like lesions. Both ESFA and reactive ESFA showed basically similar immunoreactivity suggesting differentiation toward the dermal duct. The above slight difference in immunoreactivity between both lesions may be explained due to inflammatory infiltrates associated with underlying dermatoses.     

Immunohistochemical analysis of cytokeratin expression in multiple eccrine hidrocystoma

The histologic diagnosis as eccrine hidrocystoma may contain some other cysts which do not originate from the eccrine sweat glands. Some authors have suggested that true eccrine hidrocystoma does not exist. However, multiple eccrine hidrocystoma (Robinson type) is a distinct clinical entity which is characterized by multiple translucent papules around the eyelids which appear in warm weather. Cytokeratin expression in 8 cases of multiple type of unequivocal eccrine hidrocystoma was analyzed immunohistochemically. Immunoreactivities in our cases were similar to those of eccrine dermal ducts. Therefore, we confirmed that these tumors were derived from the eccrine dermal duct, not from the other appendages, and that true eccrine hidrocystoma exists.     

Metastatic eccrine sweat gland carcinoma: case report

Eccrine sweat gland carcinoma is a rare malignancy of skin adnexa with potential aggressive growth and metastatic spread. We report here a case of eccrine carcinoma arising on a finger with widespread pulmonary metastasis. A brief synopsis of the pathological and clinical aspects of eccrine sweat gland carcinoma is presented and currently available therapeutic modalities are discussed.     

恶性小汗腺汗孔瘤

报告1例恶性小汗腺汗孔瘤。患者男,65岁。因左小腿结节5年,反复破溃出血1年就诊,皮损组织病那学检查示瘤细胞呈巢状分布于真皮内,由不典型嗜伊红鳞状细胞样细胞组成,大小不等,部分核大深染,核分裂相增多,可见大小不等的管腔样结构,部分瘤细胞团与表皮相连。诊断为恶性小汗腺汗孔瘤。     

恶性小汗腺汗孔瘤1例

报告1例恶性小汗孔瘤。患者女，75岁。头皮有一肿块30年，迅速增大，破溃3个月。皮损组织病理检查显示：肿瘤位于表皮内，由大多数基底样细胞和少数呈团块状分布的不典型嗜伊红鳞状细胞组成，部分区域可见管腔样结构。诊断：恶性小汗腺汗孔瘤。     

Histiocytoid eccrine sweat gland carcinoma of the eyelid: report of a case

This report describes the 12th documented case of histiocytoid, diffuse or signet-ring cell eccrine sweat gland carcinoma of the eyelid, a rare neoplasm that characteristically affects older men and mimics distant metastasis. Clinically, the patient was thought to have a colonic metastasis. Histologically, the neoplasm comprised sheets and cords of polygonal, eosinophilic cells, with dispersed larger, rounded single cells resembling histiocytes, and cells with cytoplasmic lumina or a signet-ring appearance. Occasional duct formation was also seen. The features were reminiscent of both the histiocytoid and lobular variants of breast carcinoma. Ultrastructurally, the presence of nonintestinal type microvilli with a length : width ratio in excess of 16 were consistent with an eccrine origin, but also raised the possibility of metastatic mesothelioma. However, a metastatic lesion was excluded by clinical and imaging investigations. There has been no recurrence 3 years after primary excision.     

Ductal eccrine carcinoma with squamous differentiation: apropos a case

Sweat gland carcinomas are rare. Given this, they can pose a diagnostic challenge especially in shave biopsy specimens. We present a case of ductal eccrine carcinoma with extensive squamoid differentiation that was repeatedly misdiagnosed by multiple dermatopathologists as squamous cell carcinoma in the initial few biopsies. As the distinction between these two neoplasms is crucial to patient management, we highlight the histologic features of this uncommon entity to highlight the potential diagnostic pitfalls.     

多发性小汗腺血管瘤样错构瘤一例

报道1例多发性小汗腺血管瘤样错构瘤.小汗腺血管瘤样错构瘤是一种少见的皮肤肿瘤.病理表现为增多的小汗腺结构和大量血管成分.本例患儿8岁,左前臂多发性皮下结节伴疼痛4年,近1年局部出现多汗、多毛.经组织病理检查结合临床表现,诊断为小汗腺血管瘤样错构瘤.浅层x线照射后效果不明显,后进行分次手术切除,疗效较佳.提示治疗小汗腺血管错构瘤选择适当的手术方案是可行的.     

Malignant eccrine spiradenoma: a new case report

Malignant eccrine spiradenoma is an extremely rare skin tumor of sweat gland origin. In most cases, it arises in pre‐existing benign eccrine spiradenoma. We report an additional case of malignant eccrine spiradenoma. The present case is of a 75‐year‐old man with malignant eccrine spiradenoma developed in the right shoulder. He had a 6‐year history of a recurrent mass that was removed 2 years ago. The patient then underwent a complete excision. The gross pathologic specimen showed a large cutaneous and subcutaneous multinodular tumor, measuring 6 cm in maximal dimension. Microscopically, there were two distinct morphological components: a benign eccrine spiradenoma and a malignant eccrine spiradenoma of low grade with extensive necrosis. Different histologic patterns were observed such as cylindromatous features. Morphological differentiation in malignant eccrine spiradenoma is variable, sometimes with almost complete loss of eccrine differentiation. Extensive sampling to look for a probable previously benign component is necessary. In the other hand, malignant changes can be easily missed without adequate sampling. Ben Brahim E, Sfia M, Tangour M, Makhlouf R, Cribier B, and Chatti S. Malignant eccrine spiradenoma: a new case report     

Papillary eccrine adenoma: immunohistochemical studies of keratin expression

Despite various studies, there are serious disagreements about the cellular differentiation of papillary eccrine adenoma. In the present study, 2 specimens of papillary eccrine adenoma were analyzed by immunohistochemical techniques, using a panel of monoclonal antibodies against keratins, to elucidate its differentiation. Histopathologically, the tumor was composed of multiple tubular structures lined by two or more layers of epithelial cells. The luminal cells of the tubules were flattened or cuboidal. The former were noted in large dilated tubules. The latter were usually observed in small-to-moderate-sized tubules, and formed intra-luminal papillary projections in some tubules. Immunohistochemically, there were two kinds of cuboidal cells in the luminal layers of the tubules. Most of the large dilated tubules and some of the small-to-moderate-sized tubules expressed immunophenotypes similar to those of the eccrine dermal duct. The other tubular structures, including the small tubules resembling those of syringoma, expressed immunophenotypes similar to those of the transitional portions between the dermal ducts and the secretory segments of eccrine glands. From the above comparative studies, papillary eccrine adenoma is considered to differentiate towards the dermal duct and the transitional portions between the dermal ducts and the secretory segments of eccrine glands.     

小汗腺汗孔瘤恶变

报告1例小汗腺汗孔瘤恶变.患者男,47岁.因左手掌皮损10年就诊.皮损表现为左手掌近小鱼际处可见直径约0.5 cm淡红色圆形肿物.组织病理检查:小汗腺汗孔瘤,增生活跃,部分区域呈非典型性.考虑患者为良性小汗腺汗孔瘤基础上恶变,并向恶性小汗腺汗孔瘤早期发展.行手术切除.     

皮肤镜辅助诊断小汗腺汗孔瘤1例

报告1例小汗腺汗孔瘤.患者男,58岁.左足跟部红色肿物10余年.皮肤科检查:左足跟腱部可见直径约1 cm的红黑色隆起性结节,质软,边界清楚,伴外周褐黑色色素沉着.皮肤镜下可见边界清晰的类圆形结节,皮损中央可见多个叶状血管,血管周围有白色晕.皮损组织病理检查:真皮内可见与表皮相连的肿瘤细胞团块,向下延展进入真皮,瘤细胞大...