Case Number : Case 1655 - 28 October Posted By: Guest

To close off the week we have a fine case from Dr Richard A Carr.

A very unusual lymphadenoma

both for site and because looks much like trichoblastoma. 

What about a lymphocyte rich spiradenoma? 

Difficult case!! Some images r really like lymphocyte rich spiradenoma. Others made me think of lymphadenoma. May be it is an adnexal lesion with mixed features. Any possibility of Brooke Spiegler?? 

Plexiform fibrohistiocytic tumor

Sorry i disagree with my own comment. This is clearly not a plex fh tumor, should focus a bit more on the cases, 

I agree with the comments of the colleagues looks like a weird lymphadenoma and should discard BS.

Agree with lympadenoma.

I favor spiradenocylindroma. Tumor is located entirely in the subcutaneous adipose tissue and shows a multinodular growth pattern with hyaline material as droplets or narrow bands within epithelial aggregates. Prominence of lymphocytes in the stroma gives this tumor a thymoma resemblance.

Unusual case!....Agree with Nitin and Robledo. The nests of cells do not show peripheral palisading or central clear cells., typical of lymphadenoma. Hyaline material is also not a feature of trichoblastoma group of lesions.

So, would favour spiradenoma/cylindroma with prominent lymphocytes.

Nice discussion.  For the reasons given by Robledo (also very welcome back) and Arti this is a spiradenoma (paucilumnal again).  BerEP4 can highlight the ductal phenotype cells as small clusters in spiradenoma whereas in lymphadenoma there is usually a peripheral pattern of the staining in the basaloid cells. The basement membrane globules were the crucial clue in this instance to a spiradenoma (or spiradenocylindroma if you prefer).

Enjoy your weekends.