Abstract
Background: Mastery of cytodiagnosis of adnexal tumors is challenging by virtue of the enormous number of individual tumors and their variant forms, the complicated nomenclature and the frequency of differentiation along two or more adnexal lines in the same tumor. Aim: The present study is undertaken to assess the application of fine needle aspiration cytology in the diagnosis of eccrine skin adnexal tumors at all possible dermal and subcutaneous sites. Material and Methods: This is a retrospective study of fine needle aspiration cytology of subcutaneous swellings over a period of two years from January 2009 to December 2010 in a tertiary care center. A total of 2400 cases of dermal and subcutaneous swellings, for which fine needle aspiration cytology was done with histological follow up, were included in the study. The aspirates were provisionally diagnosed as basaloid neoplasms of skin adnexal origin. The aspirates were further grouped into benign and malignant lesions based on cell morphology and correlation between cytological and histological diagnoses was assessed. Results: Out of the 2400 cases of subcutaneous swellings, 20 cases were provisionally diagnosed as basaloid neoplasms of skin adnexal origin. They included 12 benign and 8 malignant lesions. The benign tumors were histologically diagnosed as spiradenomas(4 cases), nodular hidradenoma(4 cases), chondroid syringomas(2 cases), cylindroma(1 case) and papillary eccrine adenoma(1 case). The malignant tumors were histologically diagnosed as sweat gland adenocarcinoma(4 cases), mucinous carcinoma of sweat gland(1 case), digital papillary adenocarcinoma (2 cases) and cutatneous adenoid cystic carcinoma (1 case). Conclusions: Overall our study established that fine needle aspiration cytology is a very simple diagnostic investigation for neoplastic nodules in the skin.
Highlights
Eccrine glands are sweat glands which are appendages of epidermis of skin [1]
20 cases were cytodiagnosed as basaloid tumors of skin adnexal origin accounting for 0.01% of neoplasms
Majority of the cases occured in the adult and elderly age groups. 35% of the tumors (7 cases) occured in the 41-60 year age group, 30%(6 cases) in the 21-40 year age group and 25%(5 cases) in the 61-80 year age group
Summary
Eccrine glands are sweat glands which are appendages of epidermis of skin [1]. They secrete sweat, serve in the regulation of heat and contribute to general cutaneous homeostasis.Tumors of eccrine glands are proliferations of eccrine ductal or glandular tissue or both in a hyalinized stroma, with lymphocytes as the main inflammatory infiltrate [2].The present study is undertaken because fine needle aspiration cytology of skin lesions is not widely practiced. Eccrine glands are sweat glands which are appendages of epidermis of skin [1]. They secrete sweat, serve in the regulation of heat and contribute to general cutaneous homeostasis. The literature contains very few reports about cytology of eccrine gland tumors and there is lack of adequate cytological diagnostic criteria of various entities. These eccrine tumors have clinicopathological resemblance to other lesions like basal cell carcinoma,cutaneous leiomyoma, neurofibroma, malignant melanoma, subcutaneous metastasis from an internal malignancy, seborrhoeic keratosis, granuloma pyogenicum,cutaneous endometriosis [2,3,4].
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