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Apocrine tumors, benign:

Five cases

Deba P Sarma, MDOmaha

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Apocrine hidrocystoma

Case 1

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F 45, mons pubis

Dermal cyst

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Cyst wall is lined by apocrine-type epithelium with decapitation secretion

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Apocrine hidrocystoma

Clinical:Solitary cystic dermal lesion in face, eyelids, axilla, pubis,prepuce.

Pathology:

Unilocular or multilocular dermal cyst.Lined by double layers of cells: outer layer of flattenedmyoepithelial cells and inner columnar cells withdecapitation secretion and dark basal nuclei.

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Apocrine hidrocystoma

Case 2

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M 80, right eyebrow

Dermal cyst lined by columnar epithelium.Cyst contains acellular fluid.

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Cyst is lined by apocrine epithelium showing decapitation secretion

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Apocrine hidrocystoma

Uncommon, solitary cyst derived fromapocrine duct occurring on the head andneck.Unilocular or multilocular dermal cyst

lined by two layers of cells: an outer layerof flattened myoepithelial cells and aninner layer of tall columnar cells with redcytoplasm and basally placed nuclei.Decapitation secretion is present. Ifsignificant papillary epithelial projectionsare seen within the cyst, the lesion iscalled an apocrine cystadenoma.

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Apocrine hidrocystoma

Case 3

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F 84, left temple

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CommentUncommon, solitary cyst derived from apocrine duct

occurring on the head and neck.Unilocular or multilocular dermal cyst lined by two layers ofcells: an outer layer of flattened myoepithelial cells and aninner layer of tall columnar cells with red cytoplasm andbasally placed nuclei.

Decapitation secretion is present. If significant papillaryepithelial projections are seen within the cyst, the lesion iscalled an apocrine cystadenoma.

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Apocrine papillary cystadenoma

Case 4

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F 65, right upper eyelid

Dermal cystic tumor showing untracystic papillary and solid epithelialgrowth pattern

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Vascular stalk of the papillary groth pattern.Note the apocrine-type epithelial cells with decapitation towards thelumen.

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Apocrine spiradenoma with granular

cell change

Case 5

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F 31, left thigh, dermal nodule

Well circumscribed, encapsulated dark dermal tumor, not connected to the epidermis.

Dark dermal nodules resemble lymph node.

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Tumor is composed of glandular structures lined by two layers of epithelial cells,small dark cuboidal cells and large clear cells. Stroma shows lymphocytic

infiltration.

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Glandular lumina contain pale eosinophilic material. Note

the small dark cells and large clear cells and lymphocytes.

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Note the decapitation secretion by the apocrine type epithelium .

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Focally, the apocrine type epithelium shows spectacular granular cell change.

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