bromochloroacetic-acid and Acrospiroma

Eccrine porocarcinoma is an uncommon sweat gland malignancy. To the best of our knowledge, there has been no report in the English literature of porocarcinoma with predominantly undifferentiated sarcomatous change. We present two cases of sarcomatoid eccrine porocarcinoma associated with a benign poroma. Case 1 pertained to an 82-year-old woman with an ulcerated chest wall tumor, and Case 2 was that of a 74-year-old woman who presented with an ulcerated plaque in the lower leg. Case 1 showed an unusual pseudo-angiosarcomatous morphology with spindle cells dissecting through collagen bundles and forming vascular like channels. Case 2 revealed high-grade malignant spindle cells with focal evidence of ductal differentiation. In both the cases, benign poromatous elements were histologically evident. Immunohistochemistry performed showed pancytokeratin positivity in spindle cells of both lesions. Epithelial membrane antigen and carcino-embryonic antigen positivity in the malignant ductal elements and focal smooth muscle actin staining of the spindle cells were demonstrated in Case 2. A brief review of relevant literature is presented.

Topics: Acrospiroma; Actins; Aged; Aged, 80 and over; Carcinoembryonic Antigen; Female; Humans; Immunohistochemistry; Keratins; Leg; Mucin-1; Muscle, Smooth; Sarcoma; Staining and Labeling; Sweat Gland Neoplasms; Thoracic Wall

Squamous differentiation in poral adnexal neoplasms is a rare event. Two cases are presented of malignant eccrine poroma in which areas of squamous differentiation showing the features of squamous cell carcinoma were present. The areas of squamous differentiation were found within the invasive components of the lesions and appeared to result from direct transformation of the poral epithelial cells. A review of the literature on this unusual phenomenon is presented.

Topics: Acrospiroma; Aged; Aged, 80 and over; Carcinoma, Squamous Cell; Cell Nucleus; Cell Transformation, Neoplastic; Cytoplasm; Cytoplasmic Granules; Foot Diseases; Humans; Hyalin; Keratinocytes; Keratins; Male; Neoplasm Invasiveness; Sweat Gland Neoplasms; Thigh

Poroid neoplasms comprise classic poroma (P), hidroacanthoma simplex (HS), dermal duct tumor (DDT), and poroid hidradenoma (PH). The 3 latter are rarely reported. Poroid cells in P have recently been identified as keratinocytes of the lowermost acrosyringium and the sweat duct ridge.. To investigate a large cohort of poroid neoplasms to better define the clinical and pathologic aspects of HS, DDT, and PH. To analyze the expression of discriminatory keratins in all 4 poroid neoplasms.. 202 P, 11 HS, 17 DDT, 31 PH, and 5 composite tumors were examined under light microscopy, and 11, 9, 10, 15, and 2, respectively, by immunohistochemistry using anti-keratin antibodies, in particular, anti-K77, specific for luminal cells of the eccrine dermal sweat duct, and Ki-67 antibody.. HS appeared later in life (66.6 years old) than P, DDT, and PH. Whereas P, DDT, and PH displayed unspecific clinical aspects, HS had most frequently the aspect of a large seborrheic keratosis with well-defined borders. HS, DDT, and PH were absent on palms and soles, but were found on the trunk, the lower limbs, and the upper limbs. Similar pathologic features were observed in all tumors, that is, a majority of poroid cells expressing K14, islands of K10-positive and K77-negative large cells. K77 expression was limited to luminal cells of intact ductal structures within the tumors.. Our data demonstrate the common histogenesis of the 4 poroid neoplasms, which seem to derive from the basal keratinocytes of the sweat duct ridge and the lower acrosyringium. The variable length of the sweat duct ridge may account for the variety of poroid neoplasms, according to the site of tumor induction along this structure.

Topics: Acanthoma; Acrospiroma; Adolescent; Adult; Aged; Aged, 80 and over; Child; Dermis; Female; Humans; Immunohistochemistry; Keratinocytes; Keratins; Ki-67 Antigen; Male; Middle Aged; Necrosis; Retrospective Studies; Sweat Gland Neoplasms; Sweat Glands; Young Adult

We report two cases of eccrine porocarcinoma (EPC), one of intrepidermal EPC (IEEPC) and one of intradermal invasive EPC (IDEPC) in an immunohistochemical study of cytokeratins (CK) using nine different anti-keratin antibodies against CK1, 7, 8, 10, 14, 16, 17, 18 and 19. IEEPC expressed terminal differentiated CK1 and CK10. In contrast, IDEPC expressed simple-epithelial keratins such as CK7, 8, 18 and 19. Keratin expression of IEEPC preserves the immunophenotypes of normal epidermis. IDEPC, however, expresses poorly differentiated keratin. These results suggest that the keratin profiles of EPC are correlated with the invasive degree and reflect the clinical prognosis of EPC.

Topics: Acrospiroma; Aged; Dermis; Eccrine Glands; Epidermis; Humans; Immunoenzyme Techniques; Keratins; Male; Neoplasm Invasiveness; Sweat Gland Neoplasms

Topics: Acrospiroma; Adult; Carcinoembryonic Antigen; Female; Humans; Immunohistochemistry; Keratins; Middle Aged; Mucin-1; Sweat Gland Neoplasms; Vulvar Neoplasms

Topics: Acrospiroma; Adult; Female; Humans; Immunohistochemistry; Keratins; Sweat Gland Neoplasms

Hidroacanthoma simplex (HS) is an uncommon poroid neoplasm confined within the epidermis. The clinical features of HS are not distinctive and histopathologically HS may be confused with clonal seborrheic keratosis (CSK) if cystic or ductal structure is not present. The purpose of our study was to differentiate HS from CSK by the immunohistochemical expressions of various cytokeratins, CEA, CD1a, and S-100 protein, as well as by the degrees of deposition of melanins and glycogen. Four cases of HS and seven cases of CSK were included in the research. In contrast with CSK, HS showed a very low density of Langerhans cells (19.9 +/- 7.7 versus 3.1 +/- 1.0 CD1a (+) cells/mm, P = 0.027) and sparse melanin deposition in the nests. However, HS could not be set apart from CSK by the expressions of cytokeratins. The nests of both HS and CSK showed very similar patterns of cytokeratin expression and seemed to be mainly composed of basaloid cells with focal differentiation toward epidermal suprabasal cells.

Topics: Acrospiroma; Biomarkers, Tumor; Clone Cells; Dermatitis, Seborrheic; Diagnosis, Differential; Glycogen; Humans; Immunoenzyme Techniques; Keratins; Langerhans Cells; Melanins; Sweat Gland Neoplasms

Topics: Acrospiroma; Cell Differentiation; Forearm; Humans; Keratins; Male; Middle Aged; Sweat Gland Neoplasms

Several aspects of sweat gland carcinomas (incidence, classification, diagnosis, and behavior) have not been definitively clarified and need to be studied further.. The clinicopathologic findings of a large series of sweat gland carcinomas, collected during a period of 15 years, are presented.. Sixty sweat gland carcinomas (41 porocarcinomas, 3 syringomatous carcinomas, 8 ductal carcinomas, 5 adenoid cystic carcinomas, and 3 mucinous carcinomas) were analyzed histologically and immunohistochemically.. Porocarcinomas were composed of eosinophilic and clear atypical cells arranged in solid-cystic lobular masses. These tumors were divided into 2 subgroups: horizontal porocarcinomas, showing a prominent intraepidermal component, and nodular porocarcinomas, which demonstrated predominant nodular growth. Syringomatous carcinomas presented keratinizing and nonkeratinizing cysts, dilated tubules (sometimes with a "tadpole" appearance), small neoplastic ducts, solid islands, and cellular cords. Ductal carcinomas were characterized by a prominent formation of tubules, solid islands, and cellular cords. Adenoid cystic carcinomas presented a characteristic pattern, showing basaloid monomorphous cells with moderately atypical nuclei, arranged in cribriform or solid islands and in tubular structures. Mucinous carcinomas were composed of moderately atypical cells with eosinophilic vacuolated cytoplasm, forming solid and cystic islands floating in large mucin pools. Immunohistochemically, cytokeratin was found in neoplastic cells in all cases, carcinoembryonic antigen was detected in 73% of cases, and actin-positive (myoepithelial) cells were not found.. Although numerous studies have been published in recent years, the histologic features, histogenesis, and classification of sweat gland carcinomas still remain controversial and need to be clarified by further studies.

Topics: Acrospiroma; Actins; Adenocarcinoma; Adenocarcinoma, Mucinous; Adenoma, Sweat Gland; Adult; Aged; Aged, 80 and over; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Child; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Middle Aged; Neoplasm Recurrence, Local; Sweat Gland Neoplasms; Sweat Glands

Hidroacanthoma simplex is a benign tumor of the skin originating from or showing differentiation to the sweat glands. It grossly resembles seborrheic keratosis of Bowen's disease and histologically shows intraepidermal focal growth of epithelial cells. Malignant transformation of this tumor is rare. We report a case of pigmented hidroacanthoma with malignant transformation in a 67-year-old woman. There was a 20-year history of a skin lesion on the right thigh, which first appeared as a small verrucous papule, progressed to a dark-brown colored patch, and then to a pigmented plaque. Histologically, the primary tumor was composed of small squamoid cells with marked cellular atypia. Most of the tumor cells were located in the epidermis. Immunohistochemically, the cytoplasm of some tumor cells showed a positive reaction for epithelial membrane antigen, but not for either carcino-embryonic antigen or the S-100 protein.

Topics: Acrospiroma; Aged; Female; Humans; Immunohistochemistry; Keratins; Mucin-1; S100 Proteins; Skin; Sweat Gland Neoplasms

There are no immunohistochemical studies on cytokeratin (CK) expression in large series of cases of apocrine poroma. In addition, detailed immunohistochemical analysis of cuticular cells, a specific type of constituent cells of poromas, has not been reported.. Using the avidin-biotin method, we compared immunostaining patterns of eleven different anti-CK antibodies in 12 cases of apocrine and 21 cases of eccrine poromas, and normal adult skin.. Poroid cells were exclusively positive for CK1/5/10/14, CK5/8 and CK14, which were expressed in the outer cells of normal dermal sweat ducts. Poroid cells were heterogeneously stained with anti-CK7, CK8/18, CK 10/11 and CK19 antibodies, which reacted in the inner cells of dermal ducts and in the secretory cells of sweat glands. The cuticular cells showed constant expression of CK1/5/ 10/14 and CK10/11, and various expression patterns of CK5/8, CK6, CK7, CK14, CK8/18, CK17, and CK19.. Based on the keratin immunohistochemistry, the neoplastic cells in eccrine and apocrine poromas are considered to be closely related to the cells of dermal sweat ducts. Also the cuticular cells are considered to occupy an intermediate spectrum between the inner and outer cells of the dermal ducts. Although it is difficult to differentiate apocrine poroma from eccrine poroma by keratin expression patterns alone, the data obtained here can be helpful in differentiation of apocrine poroma from other hair follicle-related neoplasms.

Topics: Acrospiroma; Adolescent; Adult; Aged; Aged, 80 and over; Apocrine Glands; Eccrine Glands; Female; Hair Follicle; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Skin; Sweat Gland Neoplasms

A unique case of eccrine porocarcinoma with pulmonary lymphangitis and pericardial involvement is reported. The clinical course was aggressive, leading to the death of the patient a few months after diagnosis. Certain pathologial markers of clinical aggressiveness were retrospectively investigated: p53 and Ki-67 expression were determined by means of immunohistochemistry. Angiogenesis was assessed by determination of intratumor microvessel density at the vascular 'hot spot' with the anti-CD34 monoclonal antibody and quantitative analysis using computerized image analyzer. Both primary tumor and metastatic lymph node presented immunostaining for p53 and Ki-67, with a higher degree of vascularization in the secondary lesions compared to the primary tumor. Our findings suggest a correlation between tumor vascularization and clinicopathological parameters of aggressiveness in malignant eccrine porocarcinoma. Taking into account the disappointing results of current treatments for metastatic eccrine porocarcinoma, the assay of microvessel density may be helpful in selecting the patients of high risk for recurrence or death who may benefit of anti-angiogenic therapies.

Topics: Acrospiroma; Biomarkers, Tumor; Heart Neoplasms; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Lung Neoplasms; Lymphangitis; Lymphatic Metastasis; Male; Middle Aged; Neovascularization, Pathologic; Pericardial Effusion; Sweat Gland Neoplasms; Tumor Suppressor Protein p53

The expression of cytokeratins in 10 cases of clear cell hidradenoma, including 3 cases of solid cystic hidradenoma, were examined using 21 kinds of monoclonal antibodies. We divided them into three histologic patterns: massive nests with a few lumina (M nests), nests with some tubular lumina (L nests), and nests in solid cystic hidradenomas (S nests). All hidradenomas showed similar immunoreactivities to those in the lower dermal ducts or secretory cells of normal eccrine glands. With antibodies against simple epithelial cytokeratins (CKs 7, 8, 18, and 19), however, different immunostaining was noted among the three histologic patterns. Namely, the M nests failed to react to them, although some luminal cells in the L nests revealed a positive staining. Furthermore, a majority of luminal cells in the S nests revealed a positive staining with them. Therefore, we think that the luminal cells in solid cystic hidradenoma mainly differentiate toward the secretory cells, and that the M nests mainly differentiate toward the dermal duct. Those in the L nests are thought to differentiate toward the dermal duct and the secretory cells. The proportion of the differentiation toward luminal cells of dermal ducts to the differentiation toward secretory cells was the main difference among the three nests. In addition, there was no difference in immunophenotypes between clear cells and epidermoid cells in the two kinds of hidradenomas.

Topics: Acrospiroma; Humans; Immunohistochemistry; Keratins; Retrospective Studies; Skin Neoplasms

It has been shown that an intermediate cell layer exists between a luminal cell layer and a peripheral cell layer in human eccrine sweat ducts by immunohistochemistry using anti-keratin antibodies 34 beta B4 and DE-K10. These antibodies react to cytokeratin 1 and 10 respectively, and stain the intermediate cells specifically, but not luminal cells nor peripheral cells. Cytokeratin 1 and 10 are considered to appear as a differentiated keratin in the terminal process of epidermal keratinization. We examined 5 cases of eccrine poroma with 34 beta B4 and DE-K10. Various numbers of the poroid cells reacted to these anti-keratin antibodies in 4 cases. Some positive cells were observed around the cuticular cells in two of them. The present study demonstrated that terminal differentiation in terms of keratinization can occur in eccrine poromas, and that the 34 beta B4- and DE-K10-positive cells around the cuticular cells differentiate toward the intermediate cells in cytokeratin expression profile and location.

Topics: Acrospiroma; Antibodies, Monoclonal; Cell Differentiation; Eccrine Glands; Epidermis; Histocytochemistry; Humans; Keratins; Staining and Labeling; Sweat Gland Neoplasms

There are many conditions characterized by nests of cells within the epidermis. One of them, hidroacanthoma simplex, has been regarded as an epidermal tumor differentiating to intraepidermal eccrine duct cell. We report a case of hidroacanthoma simplex with the results of immunohistochemical study. Staining for 35 beta H11 (reacting with keratin No. 8), 35 beta E12 (reacting with keratin No. 1, 5, 10, 11), S-100 protein, and CEA was negative in the tumor cell nests; these monoclonal antibodies stained the nests of eccrine poroma.

Topics: Acrospiroma; Aged; Aged, 80 and over; Biomarkers, Tumor; Female; Humans; Keratins; S100 Proteins; Sweat Gland Neoplasms

Topics: Acrospiroma; Aged; Arsenites; Biomarkers, Tumor; Biopsy; Carcinoma, Basal Cell; Diagnosis, Differential; Humans; Keratins; Keratoderma, Palmoplantar; Male; Neoplasms, Multiple Primary; Potassium Compounds; Precancerous Conditions; Skin; Skin Neoplasms

Sweat gland tumors have been classified according to their presumed physiological counterpart of the sweat apparatus. Both benign poroma and malignant porocarcinoma are thought to be acrosyringeal tumors. In order to specify this general assumption, we performed histochemistry and immunohistochemistry on paraffin sections of 29 poromas and eight porocarcinomas. In detail, we used Lapham's stain, Masson's silver impregnation, and immunoperoxidase staining with glandular marker antibodies against glycoproteins (CEA, LS59, NKI/C-3) and intermediate filament proteins (wide spectrum keratin, Cam 5.2, Vim 9(1)). Poromas disclosed some scattered S100-positive dendritic cells, red-stained cells in Lapham's method, several silver impregnated dendritic cells, and numerous cells surrounding poromas which were positive for LS59 and NKI/C-3. The labeling with wide spectrum keratin antiserum was low compared to epidermal keratinocytes. Porocarcinomas made some difference. CEA-positive single vacuolated cells could be observed, and S100-positive cells failed to show dendrites as in poromas. Some tumor cell clusters were stained weakly with LS59 and NKI/C-3 in addition to surrounding cells in both tumor entities. Three out of eight porocarcinomas disclosed sparsely distributed scattered cells weakly reactive with antibodies Cam 5.2 or Vim 9(1). In general, malignant porocarcinomas expressed a greater variety of cellular markers than benign poromas. The differentiation of both tumors, however, was directed toward inner duct cells and myoepithelium. Since myoepithelial cells are missing in normal acrosyringium, poromas and porocarcinomas are thought to be sweat gland tumors related to the distal portion of the dermal duct.

Topics: Acrospiroma; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoembryonic Antigen; Cell Differentiation; Humans; Immunohistochemistry; Keratins; Neoplasm Proteins; S100 Proteins; Sweat Gland Neoplasms; Vimentin

A single poroid neoplasm composed of three histologically distinct lesions (hidroacanthomas simplex, eccrine poroma, and dermal duct tumor) is reported. Comparative histologic, histochemical, and electron-microscopic studies revealed that each tumor subtype contained varying proportions of poroid cells, clear cells, and cuticular cells. The major component of all three neoplasms was poroid cells, which, under the electron microscope, were characterized by a few, small, poorly developed desmosomes, and were histochemically characterized by a positive succinic dehydrogenase reaction. The dermal duct tumor was cultured, and showed similar histochemical findings to the in vivo poroid cells. These results suggest that poroid cells play the most important role in the histogenesis of these three neoplasms.

Topics: Acrospiroma; Aged; Cytoplasm; Cytoplasmic Granules; Epidermis; Glycogen; Humans; Keratins; Male; Microscopy, Electron; Neoplasms, Glandular and Epithelial; Neoplasms, Multiple Primary; Skin Neoplasms; Sweat Gland Neoplasms; Tumor Cells, Cultured

Eight cases of malignant eccrine poromas were studied immunohistochemically with a broad panel of antibodies in order to better characterise the spectrum of their differentiating pathways. Special attention was paid to the expression of cytokeratins, mainly the newly recognised keratin 20. In general, the pattern of staining agreed to previous studies. Anyway, a non-expected positivity with keratin 20 was seen in two cases. The usefulness of the immunohistochemistry to discover areas with masked differentiation in adnexal tumours of the skin was once more confirmed.

Topics: Acrospiroma; Aged; Aged, 80 and over; Female; Humans; Immunohistochemistry; Intermediate Filament Proteins; Keratin-20; Keratins; Male; Middle Aged; Skin Neoplasms; Staining and Labeling

Formalin-fixed and paraffin-embedded tissue specimens of six cases of extraocular sebaceous carcinoma were studied immunohistochemically with eight anti-keratin monoclonal antibodies, 34 beta B4, 35 beta H11, Ks13.1, Ks19.1, PKK1, LP34, KL1 and AE1. The staining patterns of sebaceous carcinoma were compared with those of normal sebaceous glands and other skin cancers which should be distinguished from sebaceous carcinoma histopathologically. The other skin cancers compared were eccrine porocarcinoma, malignant clear cell hidradenoma, extramammary Paget's disease with underlying adenocarcinoma, malignant trichilemmoma, and squamous cell carcinoma. Most cases of sebaceous carcinoma were stained with 35 beta H11, Ks19.1, LP34, KL1 and AE1, while normal sebaceous glands were positive only with 35 beta H11, LP34, KL1 and AE1. By immunostaining, sebaceous carcinoma was distinguishable from extramammary Paget's disease with underlying adenocarcinoma, squamous cell carcinoma, malignant trichilemmoma, and eccrine porocarcinoma, but was not clearly distinguishable from malignant clear cell hidradenoma. These findings demonstrate that sebaceous carcinoma shows positive reactions with antibodies to simple epithelial keratin, probably as a result of neoplastic transformation, and that immunohistochemical examination using anti-keratin monoclonal antibodies is useful in distinguishing sebaceous carcinoma from several other skin cancers.

Topics: Acrospiroma; Adenocarcinoma, Sebaceous; Antibodies, Monoclonal; Carcinoma, Squamous Cell; Humans; Immunohistochemistry; Keratins; Neoplasms, Basal Cell; Paget Disease, Extramammary; Sebaceous Gland Neoplasms; Skin Neoplasms; Sweat Gland Neoplasms

Thirty-one dermal appendage tumors of sweat gland differentiation including 7 spiradenomas (SPA), 8 cylindromas (CYL), 8 acrospiromas (ACS), and 8 chondroid syringomas (CS) were analyzed using antibodies to epithelial membrane antigen (EMA), cytokeratin (AE1, AE3, CAM 5.2, 34BE12), S-100 protein, actin (ACT), and desmin (DES) to characterize the immunocytochemical profile of benign sweat gland tumors. Cytokeratin expression was variable; AE1, 34BE12, AE3, and CAM 5.2 were present in 31, 24, 23, and 22 tumors respectively; 29 tumors contained EMA. Seventeen tumors, (6 SPA, 8 CYL, 2 ACS, 1 CS) stained with antibody to alpha smooth muscle actin, and 26 (7 SPA, 7 CYL, 4 ACS, 8 CS) expressed S-100 protein. Although some prior studies had reported actin filaments on electron microscopy in both spiradenoma and cylindroma, these tumors have previously been considered to be negative for myoepithelial differentiation. All spiradenomas and cylindromas we studied demonstrated actin and/or S-100 protein positivity in basal epithelial cells, consistent with myoepithelial differentiation. The organization of actin and S-100 protein positivity displayed by the spiradenomas and cylindromas we studied suggests that the tumors are differentiated towards the secretory portion of the eccrine sweat gland.

Topics: Acrospiroma; Actins; Adenoma, Sweat Gland; Cell Transformation, Neoplastic; Desmin; Epithelium; Humans; Immune Sera; Immunohistochemistry; Keratins; Membrane Glycoproteins; Mucin-1; S100 Proteins; Sweat Gland Neoplasms; Syringoma