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Breast-nonmalignant
Benign tumors / changes
Cylindroma (dermal type)
Reviewer: Hind Nassar, M.D. in January 2009 (see Authors page)
Revised: 6 April 2010, last major update April 2010
Copyright: (c) 2002-2010, PathologyOutlines.com, Inc.
Definition
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● Very rare tumor of breast that resembles dermal counterpart (Am J Clin Path 2005;123:866)
Terminology
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● Also called dermal analog tumor
Epidemiology
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● May be associated with turban tumor syndrome (Brooke-Spiegler syndrome, OMIM #605041)
Etiology
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Clinical features
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Prognostic factors
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Case reports
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● 62 year old woman (Diagn Pathol 2009 Sep 2;4:30)
● 63 year old woman with lobular carcinoma and incidental cylindroma (Am J Surg Pathol 2001;25:823)
Treatment
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● Excision
Gross description (Macroscopy)
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● Small, well demarcated
● Often near nipple and lactiferous ducts (Am J Surg Pathol 2004;28:1070)
Gross images
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Micro description (Histopathology)
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● Jigsaw pattern of epithelial basaloid islands with focal squamous and myoepithelial differentiation
● Islands are bordered by thickened basement membrane, contain hyaline globules
● Also reactive dendritic Langerhans cells that permeate islands, clusters of sebaceous cells and a few eccrine ducts
● No nuclear pleomorphism, no mitotic figures
Micro images
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Jigsaw appearance with nests of CK7 highlights p63 highlights
basaloid cells surrounded by central larger cells peripheral cells
dense hyaline basement membrane
Dermal cylindroma
Other images: skin; PAS (skin) #1; #2
Virtual Slides
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Videos
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Cytology description
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● Small uniform cells with finely granular cytoplasm and oval nuclei
● Some cells are arranged around cylinders of dense acellular material, resembles adenoid cystic carcinoma (Acta Cytol 2004;48:853)
Cytology images
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Positive stains
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● Basement membrane and hyaline globules - PAS and type IV collagen
● Central basaloid cells - CK7
● Peripheral myoepithelial cells – p63, SMA
● Eccrine ducts - EMA and CEA
● Langerhans cells - S100 and CD1a
Negative stains
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● GCDFP-15, ER, PR, CK20
Electron microscopy descriptions
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Electron microscopy images
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Molecular / cytogenetics description
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Molecular / cytogenetics images
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Differential Diagnosis
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● Adenoid cystic carcinoma, solid variant: atypia, mitotic figures, invasive growth; no continuous thickened basement membrane (Am J Clin Path 2005;123:866)
● Basal cell carcinoma: almost always attached to epidermis, peripheral palisading, no cylinders of dense acellular material
Additional references
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End of Breast-nonmalignant > Benign tumors / changes > Cylindroma (dermal type)
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