TUBULAR APOCRINE ADENOMA
Tubular apocrine adenomas
have been discussed elsewhere. The location on a buttock is unusual.
The lack of lobular architecture, lack of modified stroma, and presence
of the malformed follicle would not be characteristic of the adenoma of anogenital mammary-like glands.
It should be noted that some tubular apocrine adenomas do not communicate with the epidermis.
This case is also interesting in that there is a malformed pilosebaceous unit that contains primitive tubular outlines, presumably apocrine precursors. Therefore the histogenesis of this particular lesion may be similar to that of nevus sebaceus of Jadassohn.
It should be noted that some tubular apocrine adenomas do not communicate with the epidermis.
This case is also interesting in that there is a malformed pilosebaceous unit that contains primitive tubular outlines, presumably apocrine precursors. Therefore the histogenesis of this particular lesion may be similar to that of nevus sebaceus of Jadassohn.
Lesion of long duration from the buttock of an adult:
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| Papillomatosis is seen over an
area where there are tubular or ductal structures in the right half of
the picture. Communication of several tubules or ducts with the
epidermis is seen in the left side of the picture. There is a malformed
follicle in the left side of the picture that is just to the right of a
vertical duct or tubule. The dermal collagen is relatively unremarkable, and the lesion does not have lobular architecture. |
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This is from the left side of the scanning power view. Composite view showing communication of ducts or tubules with the epidermis. Hypergranulosis is noted near the surface, but this is not presumptive evidence of papilloma virus etiology.. Part of the malformed follicle is in the edge of the right lower part of the picture. |
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| This is from the right side of
the scanning view. A few tips of epidermal rete ridges are at the top
of the picture. Ducts or tubules are in the dermis. Many ducts are
lined by a double layer of epithelium Only one of these has fully
developed apocrine features. The papillary projections in the lumen of
the duct that connects with the epidermis do not contain connective
tissue cores. There are no inflammatory infiltrates. |
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| The inner layer is composed of
low columnar epithelium. There is a peripheral rim of round or cuboidal
cells. Although 'mature' apocrine features are not developed, this combination is seen in a variety of apocrine tumors. |
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| Three
tubular lumina are in
this malformed follicle. The epithelium lining the tubules is
cuboidal and nondescript. It is tempting to interpret this as apocrine
in view of the location and relevance to the entire case. I do
not know what the red blobs represent. |
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