References

1. Gorva AD. Digital papillary adenoma and aggressive digital papillary Adenocarcinoma. Am J Dermatopathol 2005; 27: 546-547.

2. Duke WH, Sherrod TT, Lupton GP. Aggressive digital papillary adenocarcinoma (aggressive digital papillary adenoma and adenocarcinoma revisited). Am J Surg Pathol 2000; 24:775-784.

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Figure 1 Syringoma. There are multiple, small, firm, skin-colored papules in the axillary vault.

Figure 2 Syringoma. This magnified view shows small nests of cells with clear cytoplasm and small nuclei. Some of the nests are shaped like commas or tadpoles, and some display central ducts lined by a compact eosinophilic cuticle, as is stereotypical of syringoma. There is also associated dermal sclerosis, accounting for the firm clinical quality of a syringoma.

Figure 2 Syringoma. This magnified view shows small nests of cells with clear cytoplasm and small nuclei. Some of the nests are shaped like commas or tadpoles, and some display central ducts lined by a compact eosinophilic cuticle, as is stereotypical of syringoma. There is also associated dermal sclerosis, accounting for the firm clinical quality of a syringoma.

Figure 3 Poroma. This exophytic, scaly papule of the toe assumes a highly vascular and wart-like appearance.

Figure 5 Poroma. This high magnification view demonstrates a nest of poroid cells with monomophous, small, round or ovoid nuclei, and scant eosinophilic cytoplasm. Conspicuous central ductal differentiation is evident.

Figure 4 Poroma. At low magnification, this poroma displays an exophytic profile and shows superjacent parakeratosis and crust. The associated stroma is highly vascularized and inflamed.

Figure 5 Poroma. This high magnification view demonstrates a nest of poroid cells with monomophous, small, round or ovoid nuclei, and scant eosinophilic cytoplasm. Conspicuous central ductal differentiation is evident.

Figure 6 Hidradenoma. This multinodular lesion is partially pigmented and partially cystic and compressible.

Figure 8 Hidradenoma. This high magnification view highlights keratinocytes with pale or eosinophilic cytoplasm flanking an area of glandular differentiation, with hints of decapitation secretion at the luminal border. The contiguous stroma is sclerotic.

Figure 7 Hidradenoma. At scanning magnification, both solid and cystic areas are clearly evident within a larger circumscribed nodule. Even at low magnification, glandular areas and foci of clear cell change can be seen.

Figure 8 Hidradenoma. This high magnification view highlights keratinocytes with pale or eosinophilic cytoplasm flanking an area of glandular differentiation, with hints of decapitation secretion at the luminal border. The contiguous stroma is sclerotic.

Figure 9 Syringocystadenoma papilliferum. There is a linear array of crusted, slightly verrucous papules on the upper thigh. This linear syringocystadenoma did not occur in concert with nevus sebaceus, but the combi nation of the two is commonplace.

Figure 12 Spiradenoma. Within the subcutis, there is a circumscribed multinodular array of sizable collections of undifferentiated benign (basaloid) glandular cells. Spiradenoma is typified by an oligonodular array of sizable collections of basaloid cells, whereas cylindroma is characterized by numerous small nests of similar cells.

Figure 10 Syringocystadenoma papilliferum. The surface of the biopsy is eroded, with a subjacent papillary array of broad fronds lined by the combination of columnar apocrine epithelium and attenuated squamous epithelium.

Figure 11 Syringocystadenoma papilliferum. A high magnification view demonstrates obvious apocrine epithelium at the luminal border of a papilla and also highlights many plasma cells within its inflamed "core."

Figure 12 Spiradenoma. Within the subcutis, there is a circumscribed multinodular array of sizable collections of undifferentiated benign (basaloid) glandular cells. Spiradenoma is typified by an oligonodular array of sizable collections of basaloid cells, whereas cylindroma is characterized by numerous small nests of similar cells.

Figure 13 Spiradenoma. At higher magnification, nodules of spiradenoma demonstrate a trabecular internal configuration, with two types of cells present. There are small cells with scant cytoplasm (comprising the so-called "dark" cells) at the borders of trabe-cula and cells with pale cytoplasm (so-called "light" cells) centrally within trabecula. In actual fact, there are three cell types present, as a sprinkling of superimposed lymphocytes is also a stereotypical finding. Although most spiradenomata show no clear differentiation, foci of apocrine glandular or ductal differentiation can be found at times (a duct is evident in this image).

Figure 13 Spiradenoma. At higher magnification, nodules of spiradenoma demonstrate a trabecular internal configuration, with two types of cells present. There are small cells with scant cytoplasm (comprising the so-called "dark" cells) at the borders of trabe-cula and cells with pale cytoplasm (so-called "light" cells) centrally within trabecula. In actual fact, there are three cell types present, as a sprinkling of superimposed lymphocytes is also a stereotypical finding. Although most spiradenomata show no clear differentiation, foci of apocrine glandular or ductal differentiation can be found at times (a duct is evident in this image).

Figure 14 Cylindroma. This magnified view demonstrates many small, closely juxtaposed nests of cylindroma. Most of the nests are encircled by a thickened and [periodic acid Schiff (PAS)-D-positive] basement membrane. A few scattered small dots of PAS-positive material can also be found within the compact nests.

Figure 14 Cylindroma. This magnified view demonstrates many small, closely juxtaposed nests of cylindroma. Most of the nests are encircled by a thickened and [periodic acid Schiff (PAS)-D-positive] basement membrane. A few scattered small dots of PAS-positive material can also be found within the compact nests.

Figure 15 Porocarclnoma. This large asymmetrical ulcerated malignancy was clinically firm and showed limited mobility, reflecting its infiltrative nature.
Figure 16 Porocarcinoma. This scanning magnification view demonstrates the deeply infiltrative pattern of this carcinoma and also highlights associated dermal sclerosis. There is overlying crust as a consequence of erosion/ulceration.

Figure 17 Porocarcinoma. At high magnification, the nests of carcinoma cells vary in size and shape, and areas of distal ductal differentiation (with a cuticulated luminal border) are easily found. Much like microcys-tic adnexal carcinoma, many examples of porocarcinoma show only modest or slight nuclear atypicality, and thus the distinction from benign lesions must be based upon careful assessment of architectural parameters, including lesional circumscription.

Figure 17 Porocarcinoma. At high magnification, the nests of carcinoma cells vary in size and shape, and areas of distal ductal differentiation (with a cuticulated luminal border) are easily found. Much like microcys-tic adnexal carcinoma, many examples of porocarcinoma show only modest or slight nuclear atypicality, and thus the distinction from benign lesions must be based upon careful assessment of architectural parameters, including lesional circumscription.

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