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dermal cylindroma

Wednesday 28 September 2016

cutaneous eccrine cylindroma, cylindroma

WKP PO

Definition: A dermal cylindroma is a benign adnexal tumor, which occurs on the scalp and forehead. Cylindroma is benign and forms a nodule on the face, scalp or upper trunk.

Images

- Cylindroma

- Prominent hyaline bands and deposits in a sporadic dermal cylindroma of the scalp

Microscopy

The histology is similar to spiradenoma with nests consisting of two types of cells: small hyperchromatic cells at the periphery and larger and paler cells centrally, compact PAS+ eosinophilic basement membrane material.

However, the architecture of the nests is different, with cylindroma showing more elongated nests that appear to fit together like puzzle pieces. It is associated with mutations in the CYLD gene.

Cytlindromatosis

Multiple cylindromas ( cylindromatosis ) may grow together in a "hat-like" configuration, sometimes referred to as a turban tumor. Cylindromas are uncommon dysplasias of skin appendages.

Differential diagnosis

- trichoepithelioma

  • hair follicle tumor with basaloid cells
  • nests / nested tumor
  • dense fibrous stroma with spindle cells
  • mucin pools may be present within basaloid nests
  • lack of clefting distinguishes from basal cell carcinoma

- eccrine spiradenoma

  • Can occur both separately and in combination with cylindromas
  • Similar formation with peripheral small basaloid cells and larger paler cells centrally
  • lobulated tumor islands separated by thin fibrous tissue containing blood vessels

- basal cell carcinoma (BCC)

  • lacks tight hyaline membrane separating epithelial islands
  • mucinous stroma with clefting artifact present

See also

- cylindroma
- cylindromatosis ( Turban tumor )