Case 71 - Discussion

Uploaded: 2007-11-30, Updated: 2007-12-01



Hidradenoma Papilliferum

  • Clinical: Benign tumor of mammary-like anogenital glands or presumed apocrine origin.  Usually occurs in middle aged women.
  • Site: Restricted in the genitoperineal skin, eyelids, and axillae.
  • Gross: small  (<1cm) red-blue dermal nodule.
  • Histology
    • Circumscribed solid or partly cystic dermal tumor with no connection to the surface epithelium;
    • Contains a central cystic space with papillary projections. The papillae have fibrovascular cores;
    • Solid cellular foci are common with more complex branching and interconnecting papillae;
    • The tumor consists two cell linings cover the stalks: outer epithelial cells and inner myoepithelial cells. The epithelial cells are tall cuboidal to columnar cells with pale eosinophilic cytoplasm and monotonous nuclei;
    • Prominent apocrine changes are noted in areas.  Mitotic count is occasionally high;
    • PAS positive diastase-resistant granules are present in the apices of the large cells.
  • Differential diagnosis: adenocarcinoma


  • AFIP, nonmelanocytic tumors of the skin, series 4;