Ψ Multiple eccrine spiradenomas with a zosteriform pattern—Report of a rare case diagnosed on fine needle aspiration cytology

Abstract

FNAC, eccrine spiradenoma, multipleEccrine spiradenoma (ES) is an uncommon benign adnexal neoplasm arising from intra-dermal part of the duct of eccrine gland. 1 The committed sites are trunk, extremities and head and neck. 1 It usually presents as a tender dermal solitary nodule and rarely as multifocal with a linear zosteriform or blaschkoid distribution. 2 There are a few isolated references of multiple ES diagnosed on histopathology and only a single documented case on cytology. This case of multiple ES with a zosteriform pattern; diagnosed on fine needle aspiration cytology (FNAC) is reported for its rarity and classical clinical as well as cytological features.A 35-year-old woman presented with painful, gradually increasing swellings on the right lower extremity since approximately ten years. FIG URE 1 A: Clinical picture: Multiple, discrete, well-circumscribed, subcutaneous nodules with bluish hue, in a linear dermatomal distribution over the calf region. B: Cohesive clusters of basaloid cells with interspersed metachromatic hyaline bodies (Giemsa stain, 1003). C: Acinar arrangement of tumor cells around spherical hyaline droplet and scattered spindle cells resembling myoepithelial cells (Giemsa stain, 4003). D: Triad of epithelial-myoepithelial-lymphocytic cells. Basaloid cells showing round nuclei with inconspicuous nucleoli and scant cytoplasm. (Papanicolaou stain, 4003). E: Cluster of matured lymphocytes (Giemsa stain, 4003) She gave a history of excision of similar lesions in the past, details of which were however not available. The patient was concerned that the lesions had increased in number and size lately.Physical examination revealed multiple, discrete, well-circumscribed, subcutaneous nodules in a linear dermatomal distribution over the right calf region ( Figure 1A). The nodules ranged from 0.5 to 2 cm in size and were firm, tender and fixed to the skin. Few lesions also showed slight bluish hue of the overlying skin. Clinical impression was multiple lipofibromas. FNAC was performed from multiple nodules. Papanicolaou and Giemsa stained smears were prepared which were moderately cellular, comprising of cells in cohesive clusters, sheets, and acinar pattern ( Figure 1B). At places, cells were arranged around metachromatic/magenta spherical hyaline bodies ( Figure 1C). The cells were basaloid with scant cytoplasm, round to oval nuclei and inconspicuous nucleoli ( Figure 1D).Background showed scattered spindle cells with darker nuclei resembling

Lesiones tumorales con disposición zosteriforme

“…El espiradenoma ecrino (EE) es una neoplasia anexial benigna, poco frecuente, de crecimiento lento y causa desconocida, que se origina en el conducto intradérmico de la glándula sudorípara ecrina 1,2 . Kersting y Helwig lo describieron por primera vez en 1956 3 .…”