Breast
Other benign tumors
Cylindroma
Author: Monika Roychowdhury, M.D.
Topic Completed: 1 February 2017
Minor changes: 4 January 2021
Copyright: 2002-2021, PathologyOutlines.com, Inc.
PubMed Search: Cylindroma [title] breast
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
Radiology images
Images hosted on other servers:
Screening mammogram
Ultrasound screening
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
Clinical images
Contributed by Dr. Mark R. Wick
Cylindroma
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
Various images
Images hosted on other servers:
Basaloid cells in jigsaw puzzle pattern
Jigsaw appearance with nests of basaloid cells surrounded by dense hyaline basement membrane
CK7 highlights central larger cells
p63 highlights peripheral cells
Dermal cylindroma
Skin
PAS, skin
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
