Case Number : Case 1650 - 21 October Posted By: Guest

Another beautiful case from Dr Richard A Carr to round off the week.

Cheers, Geoff

Spiradenocylindroma maybe better than just spiradenoma !

Richard, you showed this case to Dr. Kazakov when we were in Pilsen right?

Beatiful spiradenocylindroma!!!

Spiradenoma (maybe spiradenocylindroma) with too much tubular differentiation

Spiradenoma with excessive hyaline deposits and duct all differentiation.

I have seen this case at Warwick.

I see only myoepithelial-like cells with cylindromatous arrangement...but sincerely I don't know what it is! Waiting for the diagnosis.

...and I see thymoma- like lymphocytes rich perivascular spaces but... again I'm waiting for the diagnosis. 

Both Raul and Nitin are correct they have seen the case in Pilsen and Warwick respectfully - I suspect this is a reflection of how dermpathpro is making connections across the planet! Vincenzo - you are quite correct - there are no tubules visible in these images - at least I could not see them on H&E.

2 hours ago, vincenzo polizzi said:

...and I see thymoma- like lymphocytes rich perivascular spaces but... again I'm waiting for the diagnosis. 

Check this Vincenzo:

https://www.ncbi.nlm.nih.gov/m/pubmed/18647207/

Agree with Spiradenocylindroma .

There is a prominent cribriform pattern with pseudo cysts containing mucinous material. Other areas more typically spiradenomatous.

Maybe a spiradenoma with 'adenoid cystic Ca' like areas. 

(Cant enlarge images...is that a problem others are facing too?)

Yes well done all, and especially Arti, this is a spiradenoma with adenoid cystic carcinoma-like areas.  It was extremely pauci-luminal (even on BerEP4 only very sparse weak central ductal cells but no clear cut lumina). Case also seen by Dmitry Kazakov in Pilsen who thought it was a benign lesion.