aggressive digital papillary adenocarcinoma

AGGRESSIVE DIGITAL PAPILLARY ADENOCARCINOMA

It was originally thought that there was a benign aggressive digital papillary adenoma as well as an aggressive digital papillary adenocarcinoma. Subsequent observations by Duke, Sherrod, and Lupton^ref indicated this distinction was not valid in that the behavior was similar. Tumors of this type often recur and can metastasize, sometimes with fatal results.

Papillary structures, with or without connective tissue cores, are found in these tumors. Solid areas as well as tubular differentiation without a papillary configuration can be present. Mitotic activity and cytologic atypia are variable features. The diagnosis is also partly one of exclusion; when viewed as a whole, this tumor does not have the features of any other sweat gland tumor. It does have features that resemble some examples of polymorphous low-grade adenocarcinomas of salivary gland origin and papillary breast proliferations.

Thanks to Ron Harris for lending me the glass slide.

From a finger of an adult:

Composite scan power view. There are cystic areas and solid areas. Papillary structures project into spaces.

Low power view showing an area having tubular and papillary structures.

High power view of tubular structures.

High power view from another area showing papillary fronds projecting into a space. Note the degree of nuclear atypia.

Medium power view showing a cribriform pattern of epithelial proliferation without connective tissue cores. Several mitoses are visible.

Medium power view showing intraductal or intraluminal hyperplasia with connective tissue cores.

Medium power view showing papillary epithelial processes without connective tissue cores.

High power view of a solid area within which there is mitotic activity. These mitoses did not photograph very well due to the thickness of the section.

Reference: Duke WH, Sherrod TT, Lupton GP. Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). Am J Surg Pathol. 2000 Jun;24(6):775-84

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	Low power view showing an area having tubular and papillary structures.
	High power view of tubular structures.
	High power view from another area showing papillary fronds projecting into a space. Note the degree of nuclear atypia.
	Medium power view showing a cribriform pattern of epithelial proliferation without connective tissue cores. Several mitoses are visible.
	Medium power view showing intraductal or intraluminal hyperplasia with connective tissue cores.
	Medium power view showing papillary epithelial processes without connective tissue cores.
	High power view of a solid area within which there is mitotic activity. These mitoses did not photograph very well due to the thickness of the section.