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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 October 2012, 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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thumbnail thumbnail thumbnail thumbnail

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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eMedicine (skin)

 

End of Breast-nonmalignant > Benign tumors / changes > Cylindroma (dermal type)

 

 

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