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Spiradenoma and Spiradenocylindroma With an Adenomatous or Atypical Adenomatous Component: A Clinicopathological Study of 6 Cases

Kazakov, Dmitry V MD, PhD*; Magro, Gaetano MD; Kutzner, Heinz MD; Spagnolo, Dominic V MMBS§; Yang, Yu MD; Zaspa, Oksana MD; Mukensnabl, Petr MD*; Michal, Michal MD*#

The American Journal of Dermatopathology: October 2008 - Volume 30 - Issue 5 - p 436-441
doi: 10.1097/DAD.0b013e3181812729
Original Article

We report 5 cases of spiradenoma and 1 case of spiradenocylindroma, which, in addition to areas of conventional growth, manifested an adenomatous component. This consisted of compactly situated, well-developed glands having small round lumens lined by inner pale to eosinophilic cells and surrounded by an outer well-formed peripheral layer of myoepithelial cells, which reacted with a variety of myoepithelial cell markers. In 1 case, apocrine secretion was evident in the glandular part of the lesion. In 4 of the 6 cases, the adenomatous component was a minor but significant portion of the tumors, but in 2 cases it was extensive, comprising approximately 20% of the tumor area. In 1 of these 2 cases, the luminal epithelium showed atypia including rare, atypical mitotic figures. In addition, there were foci of glands showing myoepithelial cell loss. As this alteration was limited and fairly well circumscribed within the tumor bulk, we regard it as an “atypical adenomatous component,” but we cannot exclude the possibility that this may represent an incipient apocrine carcinoma, despite uneventful follow-up. Three cases also manifested clear cell areas. Immunohistochemical studies demonstrated that myoepithelial proliferation and overgrowth accounted for the clear cell change in some of the lesions.

From the *Sikl's Department of Pathology, Medical Faculty Hospital, Charles University, Pilsen, Czech Republic; †G.F. Ingrassia's Department, Anatomic Pathology, University of Catania, Catania, Italy; ‡Dermatohistopathologische Gemeinschaftspraxis, Friedrichshafen, Germany; §Division of Tissue Pathology, PathWest Laboratory Medicine WA, Nedlands, WA, Australia; ¶Department of Pathology, Health Science Center, Peking University, Beijing, China; Department of Pathology, N.N. Blochin Russian Cancer Research Center, Moscow, Russia; and #Bioptical Laboratory, Pilsen, Czech Republic.

Reprints: Dmitry V. Kazakov, MD, Sikl's Department of Pathology, Medical Faculty Hospital, Charles University, Alej Svobody 80, 304 60 Pilsen, Czech Republic (e-mail: kazakov@medima.cz).

© 2008 Lippincott Williams & Wilkins, Inc.