Elbendary Amira, Cochran Eric, Xie Qiang, Kabigting Filamer, Pereira Leanne, Elston Dirk M, Heilman Edward
*Ackerman Academy of Dermatopathology, New York, NY; †Department of Dermatology, Kasr Alainy Faculty of Medicine, Cairo University, Egypt; ‡Kings County Hospital Center, SUNY Downstate Medical Center, New York, NY; §Department of Dermatology and Dermatologic Surgery, Medical University of South Carolina, SC; and ¶Department of Dermatology, SUNY Downstate Medical Center, New York, NY.
Am J Dermatopathol. 2016 Jun;38(6):444-7. doi: 10.1097/DAD.0000000000000599.
Hidradenoma papilliferum is a benign cutaneous adnexal neoplasm, commonly occurring in the vulva and perianal region of adult women. It has characteristic histopathological features composed of anastomosing and branching tubules, lined by columnar cells, and a basal layer of myoepithelial cells. A 39-year-old woman was evaluated for 2 asymptomatic labial masses. The histopathological examination revealed a Bartholin's cyst and a hidradenoma papilliferum. The latter contains a distinct area of oncocytic/oxyphilic metaplasia. Immunohistochemical stains revealed positive staining for gross cystic disease fluid protein (GCDFP)-15 and androgen receptor. GATA-3, a protein expressed in sweat glands, highlights a similar positive staining pattern with weaker staining in areas of oncocytic metaplasia. P63 highlighted the myoepithelial differentiation. In situ hybridization for Human Papilloma Virus 6, 11, 16, and 18 was negative. P53 was negative and Ki-67 was low, confirming its benign nature. Oncocytes are enlarged epithelial cells with voluminous eosinophilic granular cytoplasm resulting from staining of nonribosomal cytoplasmic components. Few reports documented it in hidradenoma papilliferum. Our case demonstrated a florid distinct appearance of this metaplasia. The immunoprofiles of this oncocytic metaplasia such as p53 negativity and positivity for androgen receptor and GCDFP-15 demonstrates similarity to apocrine metaplasia in the breast. The authors' case demonstrates the benign nature of oncocytic metaplasia and supports the common origin of oncocytic cells and columnar cells in hidradenoma papilliferum.
乳头汗管囊腺瘤是一种良性皮肤附属器肿瘤，常见于成年女性的外阴和肛周区域。它具有特征性的组织病理学特征，由相互吻合和分支的小管组成，内衬柱状细胞，并有一层肌上皮细胞组成的基底层。一名39岁女性因唇部2个无症状肿物接受评估。组织病理学检查显示为巴氏腺囊肿和乳头汗管囊腺瘤。后者包含一个明显的嗜酸性化生区域。免疫组织化学染色显示巨囊性疾病液体蛋白（GCDFP）-15和雄激素受体呈阳性染色。GATA-3是一种在汗腺中表达的蛋白质，其染色模式相似，但在嗜酸性化生区域染色较弱。P63突出显示了肌上皮分化。人乳头瘤病毒6、11、16和18的原位杂交为阴性。P53为阴性，Ki-67较低，证实其为良性性质。嗜酸性细胞是增大的上皮细胞，由于非核糖体细胞质成分的染色而具有大量嗜酸性颗粒状细胞质。很少有报道在乳头汗管囊腺瘤中发现这种情况。我们的病例显示了这种化生的明显外观。这种嗜酸性化生区域的免疫表型如p53阴性以及雄激素受体和GCDFP-15阳性，表明其与乳腺顶泌化生相似。作者的病例证明了嗜酸性化生的良性性质，并支持乳头汗管囊腺瘤中嗜酸性细胞和柱状细胞的共同起源。
