Table of Contents
Definition / general | Essential features | Terminology | Epidemiology | Pathophysiology | Radiology images | Case reports | Treatment | Clinical images | Gross description | Microscopic (histologic) description | Microscopic (histologic) images | Cytology description | Positive stains | Negative stains | Differential diagnosis | Additional referencesCite this page: Roychowdhury M. Cylindroma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/breastcylindroma.html. Accessed January 18th, 2021.
Definition / general
- Very rare tumor of breast that resembles dermal counterpart (Am J Clin Path 2005;123:866)
- Breast is considered a modified sweat gland, hence it can give rise to sweat gland type neoplasms
Essential features
- Benign skin adnexal tumor, rarely can arise in breast
- Histologically identical to dermal counterpart, with nests and trabeculae of cells in a "jigsaw" puzzle pattern
- Nests show peripheral myoepithelial cells (p63+), central basaloid cells (CK7+), duct-like lumina with or without secretions and are peripherally lined by thick basement membrane material (PASD+ and collagen IV+)
- Important to differentiate from adenoid cystic carcinoma
Terminology
- Also called dermal analog tumor
- "Cylindroma" was first used by Billroth in 1959 (Int J Trichology 2013;5:83), based on nests of cells surrounded by hyaline, resemble a cylinder in cross section
- Cylindroma of the breast was first described in 2001 by Gokaslan (Am J Surg Pathol 2001;25:823)
Epidemiology
- May be associated with turban tumor syndrome (Brooke-Spiegler syndrome, OMIM: Brooke-Spiegler Syndrome; BRSS)
- Brooke-Spiegler syndrome is characterized by multiple skin appendage tumors such as cylindromas, trichoepitheliomas and spiradenomas; the gene responsible for multiple cylindromas, CYLD, is localized to band 16q12-q13
Pathophysiology
- Exact cellular origin unknown; most likely a very primitive sweat gland tumor differentiating towards apocrine line
Case reports
- 61 year old woman with cylindroma of the breast (Int J Trichology 2013;5:83)
- 62 year old woman with cylindroma of the breast (Diagn Pathol 2009;4:30)
- 63 year old woman with solitary cylindroma (dermal analog tumor) of the breast (Am J Surg Pathol 2001;25:823)
Treatment
- Excision
Gross description
- Small, well demarcated
- Often near nipple and lactiferous ducts (Am J Surg Pathol 2004;28:1070)
Microscopic (histologic) description
- 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
Microscopic (histologic) images
Contributed by Dr. Mark R. Wick
Images hosted on other servers:
Cytology description
- 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)
Positive stains
Differential diagnosis
- 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