bromochloroacetic-acid and Adenoma--Sweat-Gland

A case of papillary eccrine adenoma on the right forearm of a 78-year-old Japanese woman is reported. The tumor was 1.3 cm in diameter, occupying the whole thickness of the dermis. Histologically, the tumor was composed of dilated tubules of various sizes with intraluminal papillary projections, and was surrounded by a fibrous stroma. An immunohistochemical study revealed that the proliferating tubules were composed of a single outermost layer of alpha-smooth muscle actin- and keratin 14-positive myoepithelial cells, and keratin 8-positive inner cells. This antigen expression pattern was comparable to that of the normal eccrine secretory coil, which indicates that the tumor differentiated toward the secretory coil of an eccrine sweat gland.

Topics: Actins; Adenoma, Sweat Gland; Aged; Biomarkers, Tumor; Female; Humans; Immunohistochemistry; Keratin-14; Keratins; Sweat Gland Neoplasms

The nomenclature and pathogenesis of cutaneous cysts is discussed along the lines of their pathological properties. On the basis of histological and experimental evidence it is concluded that most cysts represent benign neoplasms derived from pluripotential cells.

Topics: Adenoma, Sweat Gland; Cysts; Dermoid Cyst; Epidermal Cyst; Hamartoma; Humans; Keratins; Pilonidal Sinus; Skin Diseases; Skin Neoplasms; Sweat Gland Diseases

An eccrine spiradenoma is a rare benign tumor most often seen in the head, neck and upper trunk of young adults. Although spontaneous pain or tenderness is a typical symptom of eccrine spiradenomas, the underlying mechanism has not been fully elucidated. Here, we report the case of a 47- year-old woman who had a spiradenoma in the subcutaneous tissue of her posterior neck accompanied by agonizing pain which was triggered by pressure. Multiple nodular lesions were excised and the typical histopathological findings of spiradenoma were seen. The histopathological architecture of a disorganized nerve fiber encasing the tumor nodules appeared to correlate with the unique clinical symptom of pain.

Topics: Adenoma, Sweat Gland; Eccrine Glands; Female; Humans; Immunoenzyme Techniques; Keratins; Magnetic Resonance Imaging; Middle Aged; Neck Pain; Nerve Fibers; S100 Proteins; Sweat Gland Neoplasms

Topics: Abscess; Adenoma; Adenoma, Sweat Gland; Biomarkers; Breast Diseases; Breast Neoplasms; Female; Fistula; Humans; Keratin-7; Keratins; Mucin-1; Nipples; Paget's Disease, Mammary; Receptor, ErbB-2; Sweat Gland Neoplasms

The histogenesis and differentiation of eccrine tumors, including cylindroma, poroma, spiradenoma and syringoma, remains controversial. This controversy may be because of sporadic and incomplete studies of these neoplasms.. Ten examples each of normal eccrine structures and of four benign eccrine tumors are analyzed with antibodies to cytokeratin (CK) 7, CD34, CK6, CK10, smooth muscle actin (SMA) and CD10. These markers represent two different immunohistochemical stains for each part of the eccrine structure; CK7 and CD34 stain the secretory coil, CK6 and CK10 stain the straight duct and SMA and CD10 stain the myoepithelial cells. This redundancy in staining is performed on four benign eccrine tumors to better interpret the existing literature.. We find that CK7 is a sensitive marker for the secretory coil; both cylindromas and spiradenomas express CK7. We also find that CK6 is a marker for the inner ductal cells, while CK10 is a marker for the middle ductal cells; syringomas express both these markers. SMA appears to be a more specific marker for myoepithelial cells surrounding normal eccrine coils, and none of the studied tumors express SMA or CD10.. Our studies suggest that syringomas are tumors of the eccrine duct, while cylindromas and spiradenomas are tumors of the secretory coil.

Topics: Adenoma, Sweat Gland; Antigens, CD34; Biomarkers, Tumor; Humans; Keratins; Neprilysin; Sweat Gland Neoplasms; Sweat Glands

Poroid hidradenoma (PH), a less common subtype of poroid neoplasm (PN) than eccrine poroma (EP), has not been immunohistochemically studied before. Six cases of PH (four solitary PH and two PH coexisted with other types of PN) were included in the study. Fifteen cases of EP were also included for comparison. Hematoxylin and eosin, Masson-Zimmerman silver stain, and a variety of immunohistochemical stains were used. Microscopically, PH is not connected to the epidermis. All six PH contained small poroid cells and larger, paler cuticular cells. Some PH showed separate or clusters of sebocytes (2/6), horn cysts (1/6), juxtaposed lymphoid follicles in the stroma (1/6) and foci of keratohyaline granules (2/6), none of which was seen in the 15 EP. Immunohistochemically, the keratin distribution of PH was very similar to that of EP. PH has a very small number of Langerhans cells (significantly lower than the overlying epidermis, P=0.045), and a sparse deposition of melanin. We conclude that except the location, the histopathological and immunochemical differences between PH and EP were small. Sebaceous differentiation in two PH lesions suggested the possibility of an apocrine origin. The deeper parts of eccrine apparatus other than basaloid cells may have been more actively involved in the histogenesis of PH.

Topics: Adenoma, Sweat Gland; Aged; Cell Transformation, Neoplastic; Eccrine Glands; Epidermis; Humans; Immunohistochemistry; Keratins; Male; Melanins; Middle Aged; Skin Neoplasms; Sweat Gland Neoplasms

To clarify the features of apocrine mixed tumors (AMT) of the skin among benign neoplasms with apocrine differentiation in their relationship to follicular stem cells, we investigated the immunohistochemical expression of CK15 (LHK15 and C8/144B), which is a relatively specific marker of hair follicle stem cells in the bulge, in 35 cases of eight different benign neoplasms with presumed apocrine differentiation. All eight cases of AMT of the skin showed CK15 immunostaining of the neoplastic cells, and all four cases of syringocystadenoma papilliferum, all five cases of spiradenoma, and both cases of cylindroma also showed a focally positive reaction to CK15. None of the other benign neoplasms with presumed apocrine differentiation showed CK15 expression. In AMT of the skin, the proportion of CK15-positive cells in the follicular or sebaceous differentiation group (78.8%, average of four cases) was significantly higher than the group without this differentiation (8.8%, average of four cases). AMT of the skin are unique among benign neoplasms with apocrine differentiation in their substantial and constant CK15 expression, suggesting that they derive from multipotent epithelial stem cells in the bulge. AMT of the skin with follicular or sebaceous differentiation are considered to show an immature stage of apocrine differentiation still rich in stem cells or to originate from stem cells with an incompletely established apocrine fate. The partially positive reaction for CK15 in syringocystadenomas papilliferum and spiradenoma/cylindroma may depend on the ability to express CK15 in stem cells with an apocrine fate or result from the follicular and apocrine nature of this neoplasm.

Topics: Adenoma, Sweat Gland; Adult; Aged; Apocrine Glands; Biomarkers, Tumor; Case-Control Studies; Cystadenoma; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Sweat Gland Neoplasms

We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.

Topics: Actins; Adenoma, Sweat Gland; Biomarkers; Eccrine Glands; Female; Humans; Immunohistochemistry; Keratin-7; Keratins; Korea; Membrane Proteins; Middle Aged; Mucin-1; Muscle, Smooth; Sweat Gland Neoplasms

Topics: Adenoma, Sweat Gland; Aged, 80 and over; Carcinoma in Situ; Cystadenocarcinoma, Papillary; Epidermis; Female; Humans; Keratin-7; Keratins; Paget Disease, Extramammary; Sweat Gland Neoplasms; Syringoma

The diagnosis of hidradenocarcinoma is difficult due to a combination of factors including inconsistent nomenclature/ classification, rarity of the neoplasm, and variable morphology of cells composing the neoplasm. Immunohistochemistry has not been previously performed on a series of hidradenocarcinomas. We evaluated six cases of hidradenocarcinoma histologically and immunohistochemically using antibodies to gross cystic disease fluid protein-15 (GCDFP-15), carcino-embryonic antigen (CEA), epithelial membrane antigen (EMA), S-100 protein, keratin AE1/3, cytokeratin 5/6, p53, bcl-1, bcl-2, and Ki67. Histology suggested concurrent eccrine and apocrine differentiation of the cases. Ki67 and p53 staining was strongly positive in five of six tumors. The neoplasms stained with antibodies to CEA, S-100 protein, GCDFP-15, EMA, bcl-1, and bcl-2 in no consistent pattern. All tumors studied stained positively for keratin AE1/3 and cytokeratin 5/6. In making the diagnosis of hidradenocarcinoma, it may be unnecessary to separate hidradenocarcinoma into eccrine and apocrine categories, and although Ki67 and p53 may be helpful, histological parameters remain paramount.

Topics: Adenoma, Sweat Gland; Adult; Aged; Carcinoembryonic Antigen; Cyclin D1; Gene Expression Regulation, Neoplastic; Humans; Keratins; Ki-67 Antigen; Male; Middle Aged; Mitosis; Mucin-1; Necrosis; Proto-Oncogene Proteins c-bcl-2; S100 Proteins; Sweat Gland Neoplasms; Tumor Suppressor Protein p53

Topics: Adenoma, Sweat Gland; Diagnosis, Differential; Humans; Keratin-14; Keratin-17; Keratin-18; Keratin-7; Keratins; Papilloma; Sebaceous Gland Neoplasms; Skin Neoplasms; Sweat Gland Neoplasms

The embryologic origin of the breast is related to salivary and sweats glands. Thus, breast neoplasms may show differentiation toward these tissues, although this is a rare event in humans. We report the clinicopathologic and immunohistochemical features of a 57-year-old woman presenting with a spiradenoma that originated in breast tissue and became malignant 40 years later. Some histogenetic concepts relevant to this case are discussed, along with a brief review of this neoplasm.

Topics: Adenoma, Sweat Gland; Biomarkers, Tumor; Breast Neoplasms; Carcinoma, Skin Appendage; Female; Humans; Immunohistochemistry; Keratins; Mastectomy; Middle Aged; Mucin-1; Neoplasms, Second Primary; Sweat Gland Neoplasms

Topics: Adenoma, Sweat Gland; Biomarkers, Tumor; Eccrine Glands; Female; Fibroadenoma; Humans; Keratins; Middle Aged; Polyps; Sweat Gland Neoplasms; Treatment Outcome; Uterine Cervical Neoplasms

Tubular apocrine adenoma is a very rare sweat gland tumor. In this report, a case of tubular apocrine adenoma in association with syringocystadenoma papilliferum on the scalp is presented. The stroma of the tubular apocrine adenoma consisted of numerous, young fibroblasts with mitotic activity. It was difficult to distinguish stromal cells and epithelial cells from each other in some areas. The characteristics and differences in histopathologic and immunohistochemical findings in these tumors are described.

Topics: Adenoma, Sweat Gland; Adult; Apocrine Glands; Biomarkers, Tumor; Carcinoembryonic Antigen; Diagnosis, Differential; Humans; Immunohistochemistry; Keratins; Male; Neoplasms, Multiple Primary; S100 Proteins; Scalp; Sweat Gland Neoplasms

Several subtypes of sweat gland carcinoma have been found to demonstrate a propensity to metastasize systemically and to regional lymph nodes. The predictive value and benefit of sentinel lymph node (SLN) biopsy have been established in numerous other malignancies, but to the authors' knowledge there is little literature published to date regarding the use of SLN biopsy in patients with sweat gland carcinoma. In the current study, the authors demonstrated the utility of SLN biopsy in detecting subclinical metastases of sweat gland carcinoma, which may result in early treatment.. The authors identified five patients with malignant eccrine tumors in whom SLN biopsy was performed at the study institution. Clinical and histopathologic data were reviewed.. The five study cases included two cases of aggressive digital papillary adenocarcinoma (both occurring on upper extremity digits), two cases of hidradenocarcinoma (occurring on the knee and foot, respectively), and an eccrine carcinoma (occurring on the scalp). In each biopsy-established case, there was no clinical evidence of metastatic disease, and a wide local excision or amputation was performed with concurrent SLN biopsy. Four of 18 SLNs in 3 of the 5 patients (60%) were found to be positive for metastatic carcinoma, as identified in hematoxylin and eosin stains and/or cytokeratin immunohistochemical stains. All three lymph node-positive patients subsequently underwent regional lymphadenectomy and were found to have no evidence of additional metastases.. The results of the current study demonstrate that SLN biopsy detects subclinical metastases from sweat gland carcinomas to regional lymph nodes. SLN mapping and biopsy at the time of resection can provide useful information with which to guide early treatment. Further studies are necessary to determine whether this procedure results in a survival benefit in patients with sweat gland carcinomas.

Topics: Adenoma, Sweat Gland; Adult; Aged; Eccrine Glands; Female; Humans; Immunoenzyme Techniques; Keratins; Lymph Nodes; Lymphatic Metastasis; Male; Middle Aged; Mucin-1; Sentinel Lymph Node Biopsy; Sweat Gland Neoplasms; Time Factors

Syringocystadenoma papilliferum is a benign hamartomatous tumour of the skin. The histogenesis of this tumour is still controversial. There have been few reports regarding immunohistochemical investigations using only a limited range of antibodies and ultrastructural studies on this rare tumour.. To elucidate the immunohistochemical and ultrastructural properties of this tumour.. We investigated the immunohistological patterns of 12 different anticytokeratin (CK) antibodies and several other markers in five cases of this tumour, comparing them with the patterns in adult sweat glands. One of these cases was also evaluated ultrastructurally.. The luminal columnar cells of the tumour were mostly positive for CK7 and more than 70% were positive for CK19. These cells showed the heterogeneous expression of CK1/5/10/14, CK14 and CK5/8. These patterns were also observed in the luminal cells in the secretory or the ductal portion of the adult sweat glands. The basal cuboidal cells of the tumour almost constantly expressed CK1/5/10/14, CK5/8, CK14 and CK7 (except for one case), similar to the patterns of basal cells in the transitional portion and myoepithelial cells in the sweat glands. However, the basal tumour cells expressed CK19 and vimentin heterogeneously, and alpha-smooth muscle actin focally (three cases). Ultrastructurally, the constituent epithelial cells were mainly divided into three types: luminal cells, basal cells and clear cells. The luminal tumour cells bore features of the secretory or ductal luminal cells of sweat glands, although they were somewhat immature in appearance. The basal tumour cells were fundamentally basaloid in nature. The clear cells were undifferentiated or primitive in appearance, suggesting stem or progenitor cell properties. Transitional forms between the clear cells and the other two cell types were also identified.. The tumour epithelium was composed of several cell types demonstrating various developmental stages from the primitive clear cells to the basal cells demonstrating a tendency to differentiate toward basal cells in the apocrine transitional portion or myoepithelial lineage, or luminal cells toward the ductal or secretory epithelium. These results support the classical concept that syringocystadenoma papilliferum is a hamartomatous tumour that arises from pluripotent cells.

Topics: Adenoma, Sweat Gland; Adolescent; Adult; Aged; Biomarkers, Tumor; Child; Female; Humans; Keratins; Male; Microscopy, Electron; Middle Aged; Neoplasm Proteins; Sweat Gland Neoplasms; Sweat Glands

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

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.

Topics: Adenoma, Sweat Gland; Biomarkers, Tumor; Diagnosis, Differential; Humans; Immunoenzyme Techniques; Immunophenotyping; Keratins; Skin Neoplasms; Sweat Gland Neoplasms

Topics: Adenoma, Sweat Gland; Anal Gland Neoplasms; Animals; Condylomata Acuminata; Female; Humans; Keratins; Middle Aged; Neoplasms, Second Primary; Sweat Gland Neoplasms

We report a case of a 78-year-old woman with a tumor of the left cheek. The tumor was a well-circumscribed cystic/solid nodule with a racemiform and reticulated pattern of growth of its epithelial cells, and mucinous and fibrocytic stroma. The epithelial cords and strands were continuous with the apocrine lining of large cystic structures. The main bulk of the epithelial component was formed by the proliferation of clear cells. This tumor is an example of an unusual benign neoplasm with racemiform and retiform patterns having a histogenetical link with the folliculo-sebaceous-apocrine unit.

Topics: Adenoma, Sweat Gland; Aged; Female; Humans; Immunohistochemistry; Keratins; Skin; Skin Neoplasms

Eccrine syringofibroadenoma (ESFA) is a rare disorder which shows differentiation toward the eccrine sweat apparatus. There is a controversy concerning the pathogenesis and precise differentiation of this tumor. We report a case of ESFA and its differentiation pattern by an analysis of cytokeratin expression. Using paraffin-embedded materials, histopathological and immunohistochemical studies were performed. Staining patterns of the luminal, peripheral, and inner cells of the tumor strands closely matched or mimicked those of the luminal, outer and intermediate cells of the normal eccrine dermal duct, respectively. The case of ESFA reported revealed a pattern of differentiation suggestive of an eccrine duct origin.

Topics: Adenoma, Sweat Gland; Aged; Aged, 80 and over; Eccrine Glands; Fibroadenoma; Humans; Immunohistochemistry; Keratins; Male; Skin Neoplasms; Sweat Gland Neoplasms; Syringoma

Tubulopapillary hidradenoma is a benign sweat gland tumor that appears as a well-defined, superficially located dermal nodule. It combines ductal as well as apocrine and eccrine glandular differentiation. Microscopically, the tumor is composed of tubular structures that characteristically show intraluminal non-villous papillary projections and a peripheral myoepithelial cell layer. A tumor that is histologically and immunohistochemically identical to tubulopapillary hidradenoma occurred in the mandible of a 73-year-old man and resulted in considerable diagnostic difficulty. The neoplasm developed in a mandibular cyst and recurred 5 years after initial enucleation. This is the first report of a central (intraosseous) sweat gland adenoma of the mandible. The differential diagnosis and possible histogenesis are discussed.

Topics: Actins; Adenoma, Sweat Gland; Aged; Apocrine Glands; Bone Cysts; Cell Nucleolus; Cell Nucleus; Cell Transformation, Neoplastic; Cytoplasm; Diagnosis, Differential; Eccrine Glands; Epithelial Cells; Follow-Up Studies; Humans; Keratins; Male; Mandibular Neoplasms; Muscle, Smooth; Neoplasm Recurrence, Local; Vimentin

We carried out an immunohistochemical analysis of nine spiradenomas and seven cylindromas. Our findings underscore the histomorphological similarities of the two adnexal neoplasms-namely, the expression of S-100 protein ascribed to eccrine differentiation within the tubular and large, pale-staining cells of both entities. Human milk fat globulin (HMFG) and lysozyme, two markers associated with apocrine differentiation, are expressed by tubular cells in spiradenomas and cylindromas. Lysozyme is also expressed in cylindromas by large, pale-staining cells. In addition, antibodies to alpha-smooth muscle actin strongly characterized the small basaloid cells of both types of neoplasm. Both spiradenomas and cylindromas expressed identical cytokeratin patterns. As with the various regions of eccrine and apocrine units, the expression by spiradenomas and cylindromas of keratins 7, 8, and 18 indicates differentiation toward the secretory tissue, whereas the expression of keratin 14 in some of the neoplastic cells points toward ductal differentiation. Malformed ductal and glandular structures in continuity with evolving spiradenomas and cylindromas in two of our cases also suggest that these tumors might arise from abortive adenxal anlagen.

Topics: Actins; Adenoma; Adenoma, Sweat Gland; Apocrine Glands; Apolipoproteins; Apolipoproteins D; Biomarkers, Tumor; Carcinoembryonic Antigen; Carrier Proteins; Cell Differentiation; Cell Lineage; Eccrine Glands; Gene Expression Regulation, Neoplastic; Glycoproteins; Humans; Immunohistochemistry; Keratins; Ki-67 Antigen; Membrane Transport Proteins; Morphogenesis; Mucin-1; Muramidase; Neoplasm Proteins; S100 Proteins; Skin Neoplasms; Sweat Gland Neoplasms; Vimentin

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 intraluminal 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.

Topics: Adenoma, Sweat Gland; Adult; Antibodies, Monoclonal; Cell Differentiation; Humans; Immunohistochemistry; Keratins; Male; Sweat Gland Neoplasms; Sweat Glands

Benign cutaneous adnexal tumors displaying divergent differentiation are rare, with very few well-documented cases reported in the literature. We describe eight cases of benign adnexal tumors showing a variable combination of eccrine, apocrine, and folliculosebaceous differentiation. Clinically, all tumors presented as solitary, slowly enlarging dermal or subcutaneous nodules located in the head and neck and the extremities. Histologically, they were characterized by well-circumscribed, unencapsulated nodules composed of a lobular proliferation of epithelial cells displaying a spectrum of trichogenic, sebaceous, apocrine, and eccrine differentiation. The histological spectrum included lobules and trabeculae of basaloid cells with glandular and ductal elements, well-formed folliculosebaceous units, primitive follicles, and foci of tricholemmal keratinization. Immunohistochemical evaluation in four cases showed similar cytokeratin, carcinoembryonic antigen, and epithelial membrane antigen staining profiles as those reported for sweat gland adenomas; in addition, focal S-100 protein positivity and GCDFP-15 positivity could also be demonstrated, suggesting eccrine-apocrine differentiation. The tumors were most frequently confused histologically with other adnexal neoplasms, including sebaceoma, sebaceous adenoma, basal cell carcinoma, chondroid syringoma, and trichoepithelioma. The present series highlights the capability.

Topics: Adenoma; Adenoma, Pleomorphic; Adenoma, Sweat Gland; Adult; Aged; Aged, 80 and over; Antigens, Neoplasm; Apocrine Glands; Apolipoproteins; Apolipoproteins D; Carcinoembryonic Antigen; Carcinoma, Basal Cell; Carrier Proteins; Eccrine Glands; Epithelium; Female; Glycoproteins; Hair Follicle; Humans; Immunohistochemistry; Keratins; Male; Membrane Transport Proteins; Middle Aged; Mucin-1; Neoplasm Proteins; Neoplasms, Basal Cell; S100 Proteins; Sebaceous Gland Neoplasms; Sweat Gland Neoplasms

Eccrine syringofibroadenoma is a rare benign skin tumor, which usually develops on the extremities of elderly persons. We performed immunohistochemical and ultrastructural studies of a typical case of eccrine syringofibroadenoma that developed on the left heel of a 58-year-old man. The tumor consisted of anastomosing thin epithelial strands connected to the epidermis. There were many ductal or cystic structures, and their luminal cells were strongly positive to antibodies against carcinoembryonic antigen and epithelial membrane antigen. Filagrin and involucrin immunoreactivities were also detected in some cells surrounding the ducts. Keratins K1 and K10, co-expressed in the peripheral cells of normal acrosyringia, were colocalized in small cell clusters. Ultrastructurally, intracellular duct formation characteristic of developing acrosyringia was observed. Tumor cells containing globular keratohyaline granules with various electron densities were seen around some ductal structures. In these areas, keratinization took place without lamellar granule formation or prominent cornified cell envelope assembly. These results suggest acrosyringial differentiation of this tumor.

Topics: Adenoma, Sweat Gland; Antigens, Neoplasm; Carcinoembryonic Antigen; Cytoplasmic Granules; Eccrine Glands; Epidermis; Epithelium; Filaggrin Proteins; Foot Diseases; Humans; Hyalin; Immunohistochemistry; Intermediate Filament Proteins; Keratins; Male; Middle Aged; Mucin-1; Protein Precursors; Sweat Gland Neoplasms

We studied the immunohistochemical phenotype in 13 cases of the nodular hidradenoma (NH), with special emphasis on the expression of different types of keratins (cytokeratins, 7, 10, 6/18, 8/18, and 10/17/18 and their distribution in normal sweat glands. Variable reactions with keratins, alpha-smooth muscle actin, and epithelial membrane antigen (EMA) were found, as these markers were present in different cellular components of the tumors. The most constant finding was almost complete absence of cytokeratins (all but keratin 10/17/18, which was positive in two of 13 cases) in clear cells, which yet were positive for EMA. The tumors expressed mostly cytokeratin 6/18, 7, 8/18, and 10/17/18, which were found in 11, 13, 11, and 12 cases, respectively. The cellular distribution and quantity of stained cells differed, as keratins 6/18, 8/18, and 7 produced the most abundant staining and were predominantly localized in small squamoid cells and the cells lining the tubular and cystic spaces. Cytokeratin 10/17/18 was expressed in smaller or larger clusters of squamoid cells and rarely in clear cells. Cytokeratins 10, 19, and 20 were found sporadically in single cells or small cellular clusters. alpha-Smooth muscle actin was expressed in four cases, whereas we did not find reactivity of S-100 protein. Comparing these results with the pattern of keratin distribution and antigenic reactivity in eccrine sweat glands, we conclude that NH presents cellular heterogeneity of its elements and differentiation toward different parts of the sweat gland.

Topics: Actins; Adenoma, Sweat Gland; Biomarkers, Tumor; Coloring Agents; Eccrine Glands; Gene Expression Regulation, Neoplastic; Humans; Immunohistochemistry; Keratins; Metaplasia; Mucin-1; Phenotype; S100 Proteins; Sweat Gland Neoplasms; Sweat Glands

A case of papillary tubular adenoma is reported. On microscopic examination the lesion, located on the scalp, showed a tubular-branching pattern, opening on the skin surface, and features of decapitation secretion. Immunohistochemical evidence of both eccrine and apocrine differentiation was found. This case, which on a clinicopathological basis alone could be classified as tubular apocrine adenoma, illustrates the difficulties in contrasting the latter to its eccrine counterpart (papillary eccrine adenoma) and suggests that the terms papillary tubular adenoma or tubulopapillary hidradenoma more accurately describe these lesions.

Topics: Adenoma; Adenoma, Sweat Gland; Adenoma, Villous; Adult; Antigens, Neoplasm; Apocrine Glands; Carcinoembryonic Antigen; Cell Differentiation; Diagnosis, Differential; Eccrine Glands; Female; Humans; Immunohistochemistry; Immunophenotyping; Keratins; Mucin-1; Neoplasm Proteins; Scalp; Skin Neoplasms; Sweat Gland Neoplasms

Applying immunohistochemical procedures for the detection of eight different cytokeratin (CK) polypeptides and other differentiation markers, we compared the staining patterns of normal cutaneous structures with those of benign adnexal tumors (n = 65). Syringomas exhibited a marker pattern highly reminiscent of that seen in normal dermal eccrine ducts (EMA in peripheral cells, CK 10 in intermediate cells, and CK 6, CK 19, and CEA in luminal cells). Nodular hidradenomas exhibited complex patterns suggesting relationship between tumor cells, including clear cells, and normal secretory coil cells (CK 7, CK 8, CK 19, and EMA); however, dermal-duct and epidermoid differentiation were also detectable. In both cylindromas and spiradenomas, zonal staining patterns were apparent: modified myoepithelial cells were positive for smooth-muscle-type actin, while the luminal cells mainly expressed ductal markers (CK 6 and CK 19) and, less prominently, secretory-coil markers including CK 7. Eccrine poromas exhibited a widespread reaction for CK 5/6 and EMA, analogous to peripheral dermal duct cells, but focal maturation toward inner-ductal and secretory-coil cells was also demonstrable. The staining pattern observed in trichoepitheliomas resembled that of the outer but not the inner root sheath. In conclusion, the detailed marker profiles obtained in the present study have broadened our understanding of the differentiation and nature of these highly singular tumor types.

Topics: Adenoma; Adenoma, Sweat Gland; Antibodies, Monoclonal; Binding, Competitive; Biomarkers, Tumor; Carcinoma, Adenoid Cystic; Cell Differentiation; Epidermal Cells; Epidermis; Humans; Immunohistochemistry; Keratins; Neoplasms, Basal Cell; Reference Values; Skin Neoplasms; Sweat Glands; Syringoma

The distribution of immunoreactivity of bone morphogenetic protein (BMP), the glycosaminoglycans chondroitin 4-sulphate (C4SPG), chondroitin 6-sulphate (C6SPG), dermatan sulphate (DSPG) and keratan sulphate proteoglycans (KSPG), cytokeratin (K8.12), vimentin, glial fibrillary acidic protein (GFAP), actin, desmin, S-100 protein and neuron-specific enolase (NSE) in mixed tumour of the skin was investigated using immunohistochemical methods using monoclonal (MoAb) and polyclonal antibodies (PoAb). A strong BMP immunoreactivity was found characteristically in outer tumour cells of tubuloductal structures and modified myoepithelial cells. Modified myoepithelial cells and chondroidally changed cells showed positive immunoreactivity for C4SPG, C6SPG and DSPG; and KSPG was more pronounced in the modified myoepithelial cells. Vimentin, S-100 protein, GFAP and NSE, but not actin and desmin, were distribute in the outer tumour cells and modified myoepithelial cells in chondroidally changed tissue. Two factors show that chondrogenesis in mixed tumour of the skin is associated with the modified myoepithelial cells through the activity of BMP and biosynthesis of glycosaminoglycans as matrix substance. First, outer or basal tumour cells in mixed tumour of the skin is characterized by the presence of positive immunoreactivity for BMP, KSPG, vimentin, cytokeratin K8.12, S-100 protein, GFAP and NSE, and second, there is a matrix of chondroidally changed tissue containing the reaction products of C4SPG, C6SPG, DSPF and KSPG.

Topics: Actins; Adenoma, Sweat Gland; Bone Morphogenetic Proteins; Chondroitin Sulfate Proteoglycans; Chondroitin Sulfates; Dermatan Sulfate; Desmin; Glial Fibrillary Acidic Protein; Glycosaminoglycans; Humans; Keratan Sulfate; Keratins; Lumican; Phosphopyruvate Hydratase; Proteins; S100 Proteins; Sweat Gland Neoplasms; Vimentin

Despite light and electron microscopic and histochemical studies, there is no consensus on the cellular differentiation of eccrine spiradenoma. In the present study, eight specimens of eccrine spiradenoma were analysed by immunohistochemical techniques, using a panel of monoclonal antibodies against cytokeratins. Two types of epithelial cells were identified in tumour nodules: large, pale epithelial cells in the centre, and small, dark epithelial cells situated at the periphery. These nodules frequently contained tubular structures lined by cuboidal, columnar or, less commonly, flattened epithelial cells. Cytokeratin expression in eccrine spiradenoma was compared with expression in normal eccrine glands. Immunohistochemistry revealed that large, pale epithelial cells expressed immunophenotypes similar to those of luminal cells in the transitional portions between the secretory portions and the coiled ducts. The small, dark cells expressed immunophenotypes similar to those of basal cells in the transitional portions. Tubular structures observed in eccrine spiradenoma showed staining patterns similar to those of the luminal cells in the transitional portions. Eccrine spiradenoma may, therefore, differentiate towards the transitional portions between the secretory portions and coiled ducts of eccrine glands. Some of the large, pale epithelial cells in eccrine spiradenoma differentiate towards tubular structures, forming a lumen lined by a cuticle.

Topics: Adenoma, Sweat Gland; Eccrine Glands; Humans; Immunohistochemistry; Keratins; Sweat Gland Neoplasms

Although eccrine poroma has been thought of as a neoplasm of the intradermal eccrine duct, this interpretation has not been entirely confirmed. In this study, twenty-five cases of eccrine poroma were retrieved and analyzed by immunohistochemical techniques, using various kinds of monoclonal antikeratin antibodies. Comparative immunohistochemical observations of eccrine poroma and normal eccrine glands revealed that the poroma cells expressed immunophenotypes similar to those of the basal cells of dermal eccrine ducts. Sweat-ductlike structures showed similar staining patterns to those observed in the inner cells of dermal eccrine ducts. Some cystic spaces were similar to those observed in the secretory cells of eccrine glands. Eccrine poroma is, therefore, speculated to originate via the proliferation and expansion of the basal cells of eccrine ducts, although it is very difficult to prove the histogenesis. Some tumor cells may differentiate toward inner cells of the eccrine ducts, forming ductal lumina, whereas other tumor cells differentiate toward eccrine secretory regions, forming some cystic spaces.

Topics: Adenoma, Sweat Gland; Antibodies, Monoclonal; Eccrine Glands; Humans; Immunohistochemistry; Immunophenotyping; Keratins; Staining and Labeling; Sweat Gland Neoplasms

Brooke-Spiegler syndrome is an autosomal dominantly inherited disease characterized by the development of multiple trichoepitheliomas and cylindromas. Among other neoplasms that may also occur in Brooke-Spiegler syndrome are basal cell carcinomas and spiradenomas. Spiradenomas and cylindromas have so many features in common that they have been regarded as variants of the same neoplasm. This assumption was supported by the occurrence of both types of lesions in Brooke-Spiegler syndrome. We report a case of Brooke-Spiegler syndrome in which spiradenomas were found in the immediate vicinity of trichoepitheliomas and in continuity with follicles. Because of the embryonic relationship between follicles and apocrine glands, these features indicate that spiradenomas are apocrine neoplasms. We conclude that Brooke-Spiegler syndrome is an inherited disease that affects the folliculosebaceous apocrine unit.

Topics: Adenoma, Sweat Gland; Adult; Carcinoembryonic Antigen; Carcinoma, Adenoid Cystic; Cell Nucleus; Cytoplasm; Facial Neoplasms; Female; Humans; Keratins; Neoplasms, Multiple Primary; Neoplastic Syndromes, Hereditary; S100 Proteins; Skin Neoplasms

Four cases of chondroid syringoma containing large numbers of hyaline or plasmacytoid cells are described. Three cases occurred in the hand and one in the foot. Hyaline cells are commonly seen in mixed tumours and myoepitheliomas of salivary glands and rarely in chondroid syringomas. The hyaline-cell change in three of the cases initially caused diagnostic difficulties and the possibility of sarcoma was raised in two cases. In addition to the characteristic hyaline cells, the presence of tubulo-glandulo-ductal structures, benign squamous epithelium and myxochondroid stroma aided diagnosis. Immunohistochemically, the hyaline cells exhibited positivity for vimentin, cytokeratin, S-100 protein, carcino-embryonic antigen, focal glial fibrillary acidic protein (3 cases), neuron-specific enolase (3 cases) and focal alpha-smooth muscle actin (2 cases). Occasional cells were Ber EP4 positive (2 cases). In some cells, a striking peripheral ring-like positivity for cytokeratin and S-100 protein was noted. Ultrastructurally, desmosomes, varying numbers of tonofibrils and non-bundling intermediate filaments were seen. Scanty fine filaments with vague focal densities were detected in some cells. Our studies suggest that the hyaline cells represent modified epithelial as well as myoepithelial cells. One of our cases also exhibited collagenous spherulosis.

Topics: Actins; Adenoma, Sweat Gland; Adult; Carcinoembryonic Antigen; Cartilage; Cartilage Diseases; Female; Glial Fibrillary Acidic Protein; Humans; Immunohistochemistry; Intermediate Filaments; Keratins; Male; Microscopy, Electron; Middle Aged; Phosphopyruvate Hydratase; S100 Proteins; Vimentin

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

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.

Topics: Adenoma, Sweat Gland; Foot Diseases; Humans; Keratins; Male; Middle Aged; Sweat Gland Neoplasms

The histologic distinction between nodular hidradenoma and glomus tumor is an occasional difficult diagnostic problem. Both tumors may show circumscribed aggregates of uniform epithelioid cells, a myxoid stroma, and variable numbers of blood vessels. Especially troublesome are solid cellular hidradenomas without duct-like structures and glomus tumors without a vascular pattern. To develop an immunohistochemical profile useful in this differential diagnosis, 25 selected skin tumors and four normal glomus bodies were studied with antibodies against low molecular-weight cytokeratin (CAM 5.2), epithelial membrane antigen (EMA), carcino-embryonic antigen (CEA), S-100, and vimentin (VIM). The tumors included eight unequivocal hidradenomas, seven unequivocal glomus tumors, and 10 histologically equivocal cases, originally diagnosed as glomus tumors. In all unequivocal glomus tumors and glomus bodies, only VIM was positive. Of the eight unequivocal hidradenomas, three were positive for CAM 5.2, EMA, CEA, S-100, and VIM; two for CAM 5.2 only; one for CAM 5.2, EMA, and S-100; one for CAM 5.2, EMA, and CEA; and one for CEA only. In the histologically equivocal cases, eight were positive for VIM only, characteristic of glomus tumor; and two were positive for CAM 5.2, EMA, CEA, S-100, and VIM, and were reclassified as hidradenomas. The study suggests that morphologic criteria may not always accurately differentiate between hidradenoma and glomus tumor and that in equivocal cases immunohistochemistry may be useful in the differential diagnosis.

Topics: Adenoma, Sweat Gland; Adolescent; Adult; Aged; Antigens, Neoplasm; Arteriovenous Anastomosis; Carcinoembryonic Antigen; Child; Diagnosis, Differential; Foot Diseases; Glomus Tumor; Humans; Immunohistochemistry; Keratins; Male; Membrane Glycoproteins; Middle Aged; Mucin-1; S100 Proteins; Skin Neoplasms; Vimentin

Eight cases of apocrine (tubular branching lumina) type cutaneous mixed tumors with follicular and sebaceous differentiation are presented. All eight tumors arose on facial skin; six patients were male and two were female. The lesions showed a cystic or nodular clinical appearance and were surgically excised. Histopathological examination confirmed the diagnosis of apocrine type of cutaneous mixed tumor in each case. Follicular differentiation consisted of (a) keratinous cysts with infundibular keratinization (infundibular differentiation); (b) hair bulbs with papillary mesenchyma, matricial differentiation with basophilic, transitional, and shadow cells, trichohyaline granules, vellous hair shafts, and clear cells of the outer root sheath (anagen differentiation); and (c) epithelial columns composed of inner cells with plump oval nuclei and scant cytoplasm, and similar cells at the periphery that were arranged in a palisade, resembling the inferior segment of a normal hair follicle in telogen. Sebaceous differentiation was represented by mature sebaceous cells, either as single cells or as small islands, within epithelial tracts of the tumor. The proportion of the areas showing these different types of differentiation varied among lesions, but some follicular differentiation was always present, whereas three cases lacked sebaceous differentiation. Immunohistochemical analysis in three cases with respect to their eccrine or apocrine differentiation showed contradictory results as in a previously reported series of cutaneous mixed tumors. The presence of follicular and sebaceous differentiation in the apocrine (tubular branching lumina) type of cutaneous mixed tumor is a confirmation of the apocrine nature of this neoplasm as well as an expression of the common embryologic derivation of all elements of the folliculosebaceous-apocrine unit.

Topics: Adenoma, Sweat Gland; Adult; Aged; Antigens, Neoplasm; Apocrine Glands; Carcinoembryonic Antigen; Cell Nucleus; Cytoplasm; Cytoplasmic Granules; Epidermis; Epithelium; Facial Neoplasms; Female; Hair; Humans; Intermediate Filament Proteins; Keratins; Male; Membrane Glycoproteins; Middle Aged; Mucin-1; Nose Neoplasms; Protein Precursors; S100 Proteins; Sebaceous Glands; Sweat Gland Neoplasms

Malignant eccrine spiradenomas (MES) are exceedingly rare and their immunohistochemical and ultrastructural features have not been fully characterized. We studied two cases, one of them immunohistochemically and electron microscopically. Patient 1 had a 25-year history of multiple exophytic tumors involving the scalp, the skin of the face, and the torso. Of the lesions removed, ten were spiradenomas, two with malignant changes, and three were cylindromas. The malignant areas showed loss of tubular and nesting patterns, lack of two cell populations, and contained anaplastic cells with high mitotic rate. The immunohistochemical findings were consistent with eccrine differentiation. Patient 2 had a cystlike mass of long duration in the right groin. Histologically, the mass consisted of nodules of benign eccrine spiradenomas adjacent to a ductal-cystic mass lined by anaplastic cells, but areas of squamous and glandular differentiation were also present.. (a) Case 1 is probably the first reported MES associated with multiple spiradenomas and cylindromas. (b) Cytodifferentiation in MES is variable, sometimes with almost complete loss of eccrine differentiation. (c) Identification of adjacent spiradenomas may be required for definite diagnosis of MES. (d) Clinical history of longstanding lesions with recent fast growth warrants tissue diagnosis.

Topics: Adenoma, Sweat Gland; Adult; Aged; Aged, 80 and over; Antigens, CD; Antigens, CD34; Antigens, Neoplasm; Apolipoproteins; Apolipoproteins D; Biomarkers, Tumor; Carcinoembryonic Antigen; Carrier Proteins; Female; Glycoproteins; Humans; Keratins; Male; Membrane Glycoproteins; Membrane Transport Proteins; Middle Aged; Mucin-1; S100 Proteins; Skin Neoplasms; Sweat Gland Neoplasms

A 46-year-old man underwent excision of a left lower eyelid mass that had enlarged over a 2-month period. Pathologic examination showed the mass to be an eccrine acrospiroma, a benign adnexal tumor that rarely arises in the eyelid. Light microscopic and ultrastructural examination showed two types of cells to comprise the tumor: eosinophilic cells with intracytoplasmic tonofilaments, and clear cells with intracytoplasmic glycogen granules. Immunohistochemical stains were positive for cytokeratins AE 1,3, epithelial membrane antigen, carcinoembryonic antigen, and muscle specific actin in tumor cells.

Topics: Actins; Adenoma, Sweat Gland; Eyelid Neoplasms; Humans; Immunoenzyme Techniques; Keratins; Male; Membrane Glycoproteins; Middle Aged; Mucin-1

Human eccrine sweat gland ducts and benign and malignant eccrine poromas were studied for the expression of various cytokeratins (CK) and vimentin by applying immunoperoxidase and immunofluorescence microscopy to frozen or paraffin-embedded sections, and using two-dimensional gel electrophoresis and immunoblotting. In acrosyringia and dermal eccrine ducts, the luminal cells exhibited intense staining for CKs 1/10/11 and 19. The periluminal cell layers of acrosyringia contained CKs 1/10/11, while CK 5 was absent. In contrast, the basal cell layer of dermal ducts was only positive with the antibody against CK 5, i.e. a pattern resembling that seen in epidermal basal cells. CK 9 was detected only in keratinocytes peripherally surrounding acrosyringia. In benign poromas, gel electrophoresis revealed that CKs 5 and 14 were predominant, with CKs 6, 16 and 17 being minor components. At the immunohistochemical level CKs 1/10/11 and 19 could be further detected with varying frequency in scattered or clustered cells and/or duct-like structures. Occasionally, CK 9-positive cells were observed. Malignant poromas displayed a similar overall gel-electrophoretic pattern. Their immunohistochemical staining patterns were also similar to (albeit rather more variable than) those seen in benign poromas. Our results show that, with respect to their CK expression pattern, the majority of poroma cells resemble the basal cells of both the dermal ducts and the epidermis, while only minor and variable subpopulations acquire features present in ductal/acrosyringial luminal cells that would be indicative of poral differentiation. Thus, the matrix cells of poromas seem to be most closely related to basal cells located at the transition between the glandular epidermal ridge and dermal eccrine duct, being in no way analogous to the cells of the adult acrosyringium above the basal cell level.

Topics: Adenoma, Sweat Gland; Adult; Female; Humans; Immunohistochemistry; Keratins; Male; Middle Aged; Skin; Sweat Gland Neoplasms; Sweat Glands; Vimentin

Using immunohistochemical methods, we investigated the distribution of epithelial membrane antigen (EMA) on the normal eccrine gland, eccrine poroma and hidroacanthoma simplex. Granular membrane-associated reaction of EMA was detected on the outer cells of both the intraepidermal and the upper portion of intradermal eccrine ducts, as well as on the luminal surfaces and intercellular canaliculi of eccrine glands. Clear immunolabeling was also present in the tumor cells of eccrine poroma and hidroacanthoma simplex. Thus, it is suggested that the constituent cells of these tumors originate from the outer cells of the intraepidermal and/or the upper portion of the intradermal eccrine ducts. There was no immunolabeling for EMA on the tumor cells of seborrheic keratosis and basal cell carcinoma. Immunohistochemical staining for EMA is a useful tool for the diagnosis of skin appendage tumors.

Topics: Adenoma, Sweat Gland; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma, Basal Cell; Cell Membrane; Cytoplasm; Dermatitis, Seborrheic; Eccrine Glands; Epithelium; Humans; Immunohistochemistry; Keratins; Membrane Glycoproteins; Mucin-1; Reproducibility of Results; Skin Neoplasms

Since its initial description, microcystic adnexal carcinoma (MAC) of the skin has been controversial. In particular, it features keratin production of the type seen in some pilar neoplasms , and has been thought to pursue partial follicular differentiation. Diagnostically, MAC may be difficult to separate from desmoplastic trichoepithelioma (DTE) in superficial biopsy specimens. We studied 12 MACs, 22 malignant eccrine acrospiromas, 7 sudoriferous syringometaplasias, 6 syringomas, 5 DTEs, and 40 other benign pilar neoplasms immunohistochemically. Paraffin sections and antibodies to "hard" (pilar) keratins. epithelial membrane antigen (EMA), carcinoembryonic antigen (CEA), Leu-M1, and S100 protein were employed. The MACs exhibited reactivity for hard keratin subclasses AE 13 and AE 14, EMA, CEA, and Leu-M1. Desmoplastic trichoepitheliomas expressed positivity for AE 14, EMA, and Leu-M1 focally, but lacked the other specified markers. Syringomas and malignant acrospiromas displayed EMA, CEA, and AE 14 reactivity, and 5 syringometaplastic lesions were AE 14-reactive. Benign pilar tumors aside from DTEs were reactive only for AE 13, AE 14, or both. These data indicate that MAC exhibits an immunophenotype that is a "hybrid" of those seen in pure sweat glandular and follicular neoplasms, and suggest that it may indeed show combined pilar and sudoriferous differentiation. Based on these results, it also appears that immunohistochemical analysis may be useful in the diagnostic separation of MAC and DTE.

Topics: Adenoma, Sweat Gland; Adult; Antigens, CD; Antigens, Differentiation, Myelomonocytic; Antigens, Neoplasm; Biomarkers, Tumor; Carcinoembryonic Antigen; Carcinoma; Female; Humans; Immunohistochemistry; Keratins; Lewis X Antigen; Male; Membrane Glycoproteins; Middle Aged; Mitosis; Mucin-1; Skin; Skin Neoplasms

A case of disseminated syringomas with unusual distribution and high age of onset is reported. The 66-year-old male patient presented with multiple lesions confined to dorsum of both hands and flexor side of both forearms. Morphological and immunohistochemical studies using keratin, S-100, carcinoembryonic antigen, and epithelial membrane antigen antibodies were performed both at light microscopical and ultrastructural level. These investigations revealed the presence of keratin filament containing colloid bodies near syringomatous epithelia. Reactivity for carcinoembryonic antigen could be demonstrated on the membranes of intracytoplasmic vesicles as well as within luminal debris. Absence of S-100 and epithelial membrane antigen in the tumor and ultrastructural features indicate ductal origin of syringoma.

Topics: Adenoma, Sweat Gland; Age Factors; Aged; Arm; Carcinoembryonic Antigen; Humans; Immunohistochemistry; Keratins; Male; Protein Precursors; S100 Proteins; Skin; Skin Neoplasms

The chondroid hidradenoma (chondroid syringoma, mixed tumor of skin) is a rare benign tumor with eccrine differentiation. It is composed of both adenoid structures surrounded by a mucoid stroma and "chondroid" single cells. Tumor cells with immunoreactive calmodulin were found predominantly in the centre of adenoid structures, whereas cells expressing cytokeratin were preferable located as the margins.

Topics: Adenoma, Sweat Gland; Aged; Biomarkers, Tumor; Female; Fluorescent Antibody Technique; Humans; Keratins; Scalp; Skin Neoplasms

Eccrine spiradenoma (ES) rarely (less than 1%) occurs in infancy. These tumors differ from the conventional ES by the presence of superficial dermal nodules which display a less distinct two-cell pattern of immature adnexal epithelial cells and rarely ductule formation. These tumors may be mistaken for mesenchymal neoplasms involving the skin and subcutis of infants and young adults. Recognition of the histopathologic features and immunostains are required to make a definite diagnosis. We describe 2 cases of ES occurring in patients younger than one year. Detailed histopathologic and histochemical differential features of these tumors and mesenchymal neoplasms of the skin and subcutis commonly occurring in infants and young adults are discussed. The biologic behavior of infantile ES is benign, but complete excision is recommended to prevent recurrence. We speculate that these tumors may represent congenital hamartomatous growths.

Topics: Adenoma, Sweat Gland; Carcinoembryonic Antigen; Child; Child, Preschool; Diagnosis, Differential; Ferritins; Humans; Immunohistochemistry; Infant; Keratins; Mesenchymoma; S100 Proteins; Skin Neoplasms

The staining patterns of normal sweat glands and sweat gland-derived neoplasms using 2 monoclonal antibodies to keratins (Dako-CK1, Cam 5.2) has been assessed. Based on findings in normal glands, the differentiation of these benign neoplasms is considered, with positive evidence for apocrine and eccrine differentiation, and in the latter, differentiation to ductal or secretory type epithelia. This easily applied technique (indirect immunoperoxidase) is suitable for use in routinely processed tissue and employs 2 commercially available monoclonal antibodies. The findings may be of assistance in general surgical reporting of problematic cases.

Topics: Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Immunoenzyme Techniques; Keratins; Sweat Gland Neoplasms; Sweat Glands

A total of 34 cases (eccrine poroma: 2, cylindroma: 2, eccrine spiradenoma: 4, syringocystadenoma papilliferum: 1, hydroadenoma papilliferum: 1, clear cell hydroadenoma: 7, mixed tumour: 16) of sweat gland tumours of the skin were described in terms of immunohistochemical distribution of keratins using polyclonal anti-keratin antiserum (TK, detecting 41-56 KDa keratins) and monoclonal antibodies (KL1, 55-57 KDa; PKK1, 40, 45, 52.5 KDa). Keratin expression in eccrine poroma, spiradenoma and syringocystadenoma was similar to that in the ductal segment of normal sweat glands. Cylindroma showed usually slight staining for kertins. Tumour cells of hydroadenomas showed not so prominent staining for any of the keratins; however, histologically, tumour cells indicated marked variation, and the degree of keratin proteins also was different among these histological variants. Mixed tumours of the skin were strongly decorated with anti-keratin antibodies along the luminal surface cells of typical structures, while no staining occurred in outer side cells. Luminal tumour cells may be differentiated from secretory coil cells, whereas outer side cells may have a myoepithelial origin, as outer layer cells found in pleomorphic adenoma of salivary glands.

Topics: Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Humans; Keratins; Staining and Labeling; Sweat Gland Neoplasms; Sweat Glands

Topics: Adenoma, Sweat Gland; Carcinoembryonic Antigen; Humans; Immunoenzyme Techniques; Keratins; Male; Microscopy, Electron; Middle Aged; Myosins; S100 Proteins; Secretory Component; Sweat Gland Neoplasms

The clinicopathology of 13 cases of chondroid syringoma were examined. The ages of the patients ranged from 26 to 86 years, with an average of 48 years. There were eight males and five females. Ten tumors out of the thirteen appeared on the face. Only one patient out of ten was suspected of recurrence in follow-up information. Histologically, all tumors consisted of epithelial cells, chondroid or myxoid matrix, and other strumal elements. The tumors were histologically classified into two types; twelve tumors had tubular and cystic lumina lined by two layers of epithelial cells, and only one case had small lumina lined by only a single layer. By an immunohistochemical study with a PAP method, positive stainings of keratin were observed in all cases, and S-100 protein in all but one. Ultrastructurally, the tumor cells showed features of an epithelial cell. Some ultrastructural differences were noted between two types of chondroid syringoma. Type I tumor cells had many tonofilaments in cytoplasm, but cytoplasmic filaments in type II were of the intermediate-type.

Topics: Adenoma, Sweat Gland; Adult; Aged; Aged, 80 and over; Cell Nucleus; Cytoskeleton; Female; Humans; Immunoenzyme Techniques; Keratins; Male; Microscopy, Electron; Middle Aged; Organoids; Recurrence; S100 Proteins; Skin Neoplasms

Topics: Adenoma, Sweat Gland; Adult; Aged; Carcinoembryonic Antigen; Female; Humans; Keratins; Male; Microscopy, Electron; Middle Aged; S100 Proteins; Skin Neoplasms

One hundred cutaneous tumors were investigated immunohistopathologically for the expression of intermediate filament (IF) proteins. Epithelial tumors, such as basocellular and squamous cell carcinomas, cutaneous adnexal tumors, and metastatic carcinomas showed keratin positivity in a varying number of tumor cells with two keratin antibodies with different specificities. Neoplastic cells of fibrohistiocytic tumors, pigmented nevi, melanomas, hemangiomas, glomus tumors, and lymphomas were positive for vimentin, but not for keratin or desmin. Cutaneous leiomyomas and leiomyosarcomas, on the other hand, were positive for desmin. The results show that the typing of IFs enables the differential diagnosis between carcinomas and sarcomas or melanomas, epidermal appendage tumors, and mesenchymal tumors, and between fibrohistiocytic and leiomyocytic tumors, and therefore are of diagnostic value in histopathologic problems of the skin.

Topics: Adenocarcinoma; Adenoma, Sweat Gland; Antibodies, Monoclonal; Carcinoma, Adenoid Cystic; Carcinoma, Basal Cell; Carcinoma, Renal Cell; Carcinoma, Squamous Cell; Desmin; Diagnosis, Differential; Fluorescent Antibody Technique; Hemangioma; Histiocytoma, Benign Fibrous; Histocytochemistry; Humans; Intermediate Filament Proteins; Keratins; Leiomyoma; Melanoma; Neoplasm Metastasis; Nevus, Pigmented; Skin Neoplasms; Vimentin

Topics: Adenoma, Sweat Gland; Adolescent; Cell Aggregation; Cell Nucleolus; Cell Nucleus; Cell Wall; Cytoplasm; Cytoplasmic Granules; Endoplasmic Reticulum; Epithelial Cells; Female; Glycogen; Golgi Apparatus; Humans; Keratins; Microscopy; Microscopy, Electron; Middle Aged; Mitochondria; Sweat Gland Neoplasms; Synaptic Vesicles; Vulvar Neoplasms

Topics: Adenoma, Sweat Gland; Adolescent; Aged; Collagen; Cytoplasmic Granules; Desmosomes; Ear, External; Epithelial Cells; Female; Glycogen; Humans; Inclusion Bodies; Infant; Keratins; Leukocytes; Lipids; Lysosomes; Macrophages; Male; Melanocytes; Microscopy, Electron; Mitochondria; Mucus; Neutrophils; Skin Neoplasms