The overlap in histopathologic features and immunoprofile of eccrine and apocrine neoplasms confounds basic issues relating to lineage of these entities.
We evaluated expression of follicular stem-cell markers, cytokeratin (CK) 15 and nestin, in 78 benign and 23 malignant adnexal neoplasms.
CK15 and nestin expression were noted in 39 of 78 (50%) and 36 of 78 (46%) cases in the benign group, respectively (8 cutaneous mixed tumor, 10 hidradenoma papilliferum, 9 apocrine cystadenoma, 11 cylindroma and/or spiradenoma, and 9 poroma/dermal duct tumor). CK15 and nestin expression were noted in 11 of 23 (48%) and 7 of 23 (30%) cases in the malignant group, respectively (6 microcystic adnexal carcinoma, 7 porocarcinoma, and 9 eccrine carcinoma). Except 1, both markers were negative in 4 syringocystadenoma papilliferum, 10 hidradenoma, 1 syringofibroadenoma, 10 syringoma, 1 eccrine adenoma, 8 poroma/dermal duct tumor, 5 eccrine hidrocystoma, and 1 apocrine carcinoma.
Given that follicular germinative cells give rise to the folliculosebaceous apocrine unit, expression of CK15 and nestin in the majority of cutaneous mixed tumor, hidradenoma papilliferum, apocrine cystadenoma, and cylindroma/spiradenoma is suggestive of an apocrine origin/differentiation of these neoplasms. Reinforcing this and a novel finding of our study is the preferential expression of nestin in myoepithelial cells of these lesions.
From the *Dermatopathology Section, Department of Dermatology, Boston University School of Medicine, Boston, MA; and †Dermatopathology Unit, Department of Pathology, Massachusetts General Hospital and Harvard Medical School, Boston, MA.
Conflicts of interest: none.
Reprints: Mai P. Hoang, MD, Dermatopathology Unit, Massachusetts General Hospital, 55 Fruit Street, Warren 820, Boston, MA 02114 (e-mail: firstname.lastname@example.org).