An Electron Microscopic Study

Jitsukawa, Kumiko; Sueki, Hirohiko; Sato, Syozo; Anzai, Takashi

doi:10.1097/00000372-198704000-00003

Cited by 133 publications

(14 citation statements)

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“…Intracytoplasmic lumina have been identified in other ultrastructural studies of eccrine spiradenoma. 6 It is difficult to predict the prognosis of carcinosarcoma developing in eccrine spiradenoma as so few cases have been reported. Of the cases described by McKee et al,3 one patient died with pelvic and hepatic metastases within two years of diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Malignant eccrine spiradenoma with carcinomatous and sarcomatous elements.

McCluggage

Fon

O'Rourke

et al. 1997

Journal of Clinical Pathology

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A case ofa 60 year old man with malignant eccrine spiradenoma involving the perineum is described. Areas of typical eccrine spiradenoma were admixed with carcinomatous and sarcomatous elements. Immunohistochemical and ultrastructural analysis revealed no evidence of epithelial differentiation in the sarcomatous areas. The tumour qualified for the designation carcinosarcoma arising in eccrine spiradenoma. The clinical course was aggressive with rapid development of nodal and pulmonary metastases. Histology showed an intact epidermis with no evidence of dysplasia. A tumour was present within the dermis and subcutaneous fat. This had a variegated appearance and included areas of typical eccrine spiradenoma ( fig 1A). On high power examination two cell types were identified. Cells with round to ovoid nuclei containing evenly dispersed pale chromatin were admixed with smaller cells that had round hyperchromatic nuclei. Ductular structures were also present. In these areas, there was little nuclear pleomorphism and only an occasional mitotic figure was identified. Adjacent to the typical eccrine spiradenoma, carcinomatous areas were present ( fig 1B). Here, groups and cords of epithelioid cells were surrounded by a fibrovascular stroma. Again two cell types and glandular structures were present. However, tumour cell nuclei were pleomorphic with prominent nucleoli and mitotic figures were easily identified (mitotic count in the region of 10 in 10 high power fields).At the deep aspect of the neoplasm, sarcomatous areas were present (fig 1 C). Tumour cells were spindle shaped with no glandular formation or other discernible arrangement. There was marked nuclear pleomorphism with many multinucleate tumour giant cells. Tumour cells contained moderate to abundant eosinophilic cytoplasm, but cross striations were not identified. Numerous mitotic figures were present (mitotic count in the region of 20 in 10 high power fields), and there were large areas of necrosis. No chondroid areas or areas of osteoid formation were identified.Histology of several of the satellite lesions showed them to be composed of typical eccrine spiradenoma, located in the dermis.Sectioning of the left inguinal lymph node dissection specimen revealed several nodes, one of which was enlarged and necrotic. Histology of this node showed it to be almost totally replaced by metastatic tumour that was extensively necrotic. In areas, the tumour had a carcinomatous appearance, similar to the carcinomatous areas within the skin neoplasm. However, elsewhere the tumour had a sarcomatous appearance, identical to the corresponding areas within the cutaneous neoplasm.The other nodes showed no evidence of metastatic tumour.

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Section: Discussionmentioning

confidence: 99%

Malignant eccrine spiradenoma with carcinomatous and sarcomatous elements.

McCluggage

Fon

O'Rourke

et al. 1997

Journal of Clinical Pathology

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“…3,4 Myoepithelial cells, although commonly encountered in classical spiradenoma and spiradenocylindroma, are not evident at the light microscopic level, but they are convincingly demonstrated by electron microscopy and immunohistochemistry. [5][6][7][8][9] Further morphologic variations include squamous, mucinous, and clear cell differentiation. Malignant transformation results in distinctive appearances including patterns resembling basal cell adenocarcinoma of the salivary gland, either low grade or high grade, infiltrating adenocarcinoma, or sarcomatoid (metaplastic) carcinoma.…”

Section: Introductionmentioning

confidence: 99%

Adenoid Cystic Carcinoma-Like Pattern in Spiradenoma and Spiradenocylindroma: A Rare Feature in Sporadic Neoplasms and Those Associated With Brooke-Spiegler Syndrome

Petersson

Kutzner²,

Spagnolo³

et al. 2009

The American Journal of Dermatopathology

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Spiradenoma is a benign, morphologically well-defined cutaneous adnexal neoplasm that is closely related to cylindroma. We present the rare occurrence of adenoid cystic carcinoma (ACC)-like areas in 7 spiradenomas and 1 spiradenocylindroma, not described in the English literature to date. The ACC-like areas were a minor but significant component in all lesions and were usually multifocal and blended with the conventionally appearing parts of the neoplasms. The ACC-like areas were typified by cribriform formations of epithelial cells concentrically arranged around gland-like spaces filled with mucin, homogeneous eosinophilic material, or granular basophilic material. In some neoplasms, only mucin occurred in these pseudoglandular structures, whereas in other cases, a combination of all 3 secretory products was encountered. Although well-developed bilayered glands with a demonstrable peripheral myoepithelial cell layer were not recognizable in the ACC-like areas, immunohistochemistry demonstrated myoepithelial differentiation in these portions of the tumors. When present in the ACC-like areas, ductal structures manifested a rather squamoid lining, without a recognizable peripheral myoepithelial cell layer. It is concluded that the ACC-like pattern, although a rare feature and of no clinical consequence, is a distinctive finding in a minority of cases and extends the morphological spectrum of spiradenoma and spiradenocylindroma occurring sporadically or in the setting of Brooke-Spiegler syndrome. It represents a potential diagnostic pitfall, particularly in a limited biopsy specimen where the changes may be misdiagnosed as ACC.

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“…These have been convincingly demonstrated by electron microscopy and immunohistochemistry. [9][10][11][12][13] Immunohistochemically, these cells have an incomplete myoepithelial cell phenotype. They are often p63 positive but usually lack simultaneous expression of S-100 protein or alpha-smooth muscle actin.…”

Section: Introductionmentioning

confidence: 99%

Spiradenoma and Spiradenocylindroma With an Adenomatous or Atypical Adenomatous Component: A Clinicopathological Study of 6 Cases

Kazakov

Magro²,

Kutzner³

et al. 2008

The American Journal of Dermatopathology

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We report 5 cases of spiradenoma and 1 case of spiradenocylindroma, which, in addition to areas of conventional growth, manifested an adenomatous component. This consisted of compactly situated, well-developed glands having small round lumens lined by inner pale to eosinophilic cells and surrounded by an outer well-formed peripheral layer of myoepithelial cells, which reacted with a variety of myoepithelial cell markers. In 1 case, apocrine secretion was evident in the glandular part of the lesion. In 4 of the 6 cases, the adenomatous component was a minor but significant portion of the tumors, but in 2 cases it was extensive, comprising approximately 20% of the tumor area. In 1 of these 2 cases, the luminal epithelium showed atypia including rare, atypical mitotic figures. In addition, there were foci of glands showing myoepithelial cell loss. As this alteration was limited and fairly well circumscribed within the tumor bulk, we regard it as an "atypical adenomatous component," but we cannot exclude the possibility that this may represent an incipient apocrine carcinoma, despite uneventful follow-up. Three cases also manifested clear cell areas. Immunohistochemical studies demonstrated that myoepithelial proliferation and overgrowth accounted for the clear cell change in some of the lesions.

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An Electron Microscopic Study

Cited by 133 publications

References 0 publications

Malignant eccrine spiradenoma with carcinomatous and sarcomatous elements.

Malignant eccrine spiradenoma with carcinomatous and sarcomatous elements.

Adenoid Cystic Carcinoma-Like Pattern in Spiradenoma and Spiradenocylindroma: A Rare Feature in Sporadic Neoplasms and Those Associated With Brooke-Spiegler Syndrome

Spiradenoma and Spiradenocylindroma With an Adenomatous or Atypical Adenomatous Component: A Clinicopathological Study of 6 Cases

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