National Journal of Laboratory Medicine (Oct 2016)
A Morphologic Study of Cutaneous Adnexal Tumours
Abstract
Introduction: Cutaneous adnexal tumour is a collective term for tumours arising from various adnexal units of the skin. These tumours share many common features even though they differentiate along one line. They can only be categorized on microscopic examination and not by clinical manifestations. Their microscopic classification also is difficult owing to the variety of tissue elements, patterns and metaplastic transformations in these tumours. Aim: To review and classify all dermal adnexal tumours diagnosed in the Pathology Department of SMVMCH over the period of six years spanning from January 2007 to December 2012, and also to differentiate dermal adnexal tumours from other cutaneous tumours by pattern recognition (morphological identification of varied histopathological features). Materials and Methods: All adnexal tumours diagnosed in the Pathology Department of Sri Manakula Vinayagar Medical College and Hospital (SMVMCH) over the period of six years was studied. The Haematoxylin and Eosin stained slides were analysed for patterns to differentiate each entity from other cutaneous tumours. Results: Twenty adnexal tumours were diagnosed over a period of six years. Clinical presentations varied from discrete swellings and nodules to ulcerated masses. Most of the lesions were distributed in the head, neck and extremities. Histologically 17 cases were benign and three tumours were malignant. Commonest tumour encountered was eccrine acrospiroma followed by pilomatricoma and syringoma. Malignant tumours encountered were eccrine porocarcinoma, malignant eccrine spiradenoma and malignant adnexal tumour. Conclusion: Cutaneous adnexal tumours are complex due to their diverse origin and varied histological appearance. Many of these entities have morphological overlap. Although majorities of adnexal tumours are benign, malignant counterparts are also rarely encountered, causing further diagnostic difficulties. By far the commonest variant in the present study was of eccrine sweat gland origin.
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