Digital papillary adenocarcinoma

Case 1396   29.10.15  (H. Diwan)  M 40 palm 

Lobules containing ductal structures lined with two layers of cells, papillary in places.  Hyaline fibrous stroma. Cytology quite bland.   

Case 1639  6.10.16 (H Diwan)  M 54 finger web space lesion 

Ductal tumour with two lining layers.  Cytology only mildly atypical. 

Case 2425 16.10.19  (H. Diwan)  M  75 “cyst” heel 

Looked like cystic hidradenoma, but had papillary morphology with a myoepithelial layer.  P63 stains clear cells in hidradenoma, and myoepithelial cells in DPA.  HPV42 is +ve in all DPA – low risk HPV 

Ref:  Am J Dermatopathol  2016  40: 410-18. 

Case 2182  19.10.18  (R. Carr)  M 55 middle finger 

Superficial part arising from epidermis looks like poroma or spiradenoma.  Cystic structure underneath doesn’t show the usual papillary projections very much. Lining of cyst shows a rather glomus-like double layer of cells.  The deeper more malignant areas show dual myoepithelial and epithelial differentiation.  P63+ve, helps to distinguish this from poroma, hidradenoma and metastatic adenocarcinoma. 

Ref: Lim,S.  Korean J Pathol. 2014 Dec; 48(6): 438–441 

Case 4042  19.7.22 (U. Sundram)  M 79 finger mass 

This example rather more cytologically malignant than the others, above.