Cutaneous Lymphadenoma Report of 2 Cases

Abstract

Cutaneous lymphadenoma is a recently described tumor with a distinctive histological picture associating a basaloid epithelial proliferation and intraepithelial lymphocytes; it seems to represent a benign adnexal neoplasm of uncertain histogenesis. We documented 2 additional examples of cutaneous lymphadenoma with typical histological features; the contiguity of some tumor lobules with preexisting follicular structures was noted. In 1 case, a cutaneous osteoma was present below the tumor. On immunostainings, S-100 protein revealed numerous dendritic intraepithelial and stromal cells. The basaloid proliferation was positive for broad-spectrum keratin antibodies, but negative for KL1 antibody. In addition, several areas were positive for involucrin within tumor lobules. Our findings are consistent with a pilosebaceous origin of cutaneous lymphadenoma.

Cutaneous lymphadenoma is distinct from basal cell carcinoma

“…Connective tissue in CL is densely fibrotic similar to trichoepitheiioma and trichoblastoma [3]. Our immunohistochemistry results mainly agree with the literature [2,5,9]. We found extensive LCA staining in the lympho-histiocytic compartment of tumor lobules and in surrounding stromal infiltrates.…”

Lymphotropic Adamantinoid Trichoblastoma

“…The clinical impression for these lesions is usually that of basal cell carcinoma (1,7,8,12,14,21–23), adnexal tumor (11,14,19,20), melanocytic nevus (8,10), cyst (as in our patient) (17,19), or dermatofibroma (as in the previous adolescent) (1).…”

“…Initially described by Santa Cruz and Barr in 1987 as ‘‘lymphoepithelial tumor of the skin’’ (2), and later renamed by the same authors in 1991 as ‘‘cutaneous lymphadenoma’’ (3), this uncommon skin adnexal tumor usually presents as an asymptomatic, small, dome‐shaped, flesh‐colored papule or nodule, typically in the head and neck region (1–26). To date, 48 instances of this tumor have been described in the literature, most commonly in young to middle aged adults (age range: 14–75 yrs, mean: 43 yrs), with a predominance of male patients (M:F ratio =27:21) (1–26). These tumors have mostly been described in case reports as solitary or sporadic lesions, in contrast to other skin adnexal tumors, which may rarely be cutaneous manifestations of hereditary disorders or syndromes (27,28).…”

“…The term lymphotropic adamantinoid trichoblastoma is proposed for an uncommon benign skin adnexal (follicular) neoplasm with a prominent lymphocytic infiltrate and an adamantinoid appearance (similar to dental adamantinoma) (1–26). Only one previous occurrence of this tumor has been described in an adolescent patient (1).…”

Mohs Micrographic Surgery for Cutaneous Lymphadenoma

“…Santa Cruz and Barr first described it as a lymphoepithelial tumor and later renamed the neoplasm cutaneous lymphadenoma . Originally, the tumor was thought to be derived from an immature pilosebaceous unit . Evidence supporting the pilosebaceous hypothesis included the presence of occasional sebaceous cells within the tumor lobules and connections with follicular structures.…”