What is your diagnosis?What is your diagnosis?

Deba P Sarma, MDDeba P Sarma, MD

OmahaOmaha

M 37, left thigh, painful noduleM 37, left thigh, painful nodule

Diagnosis:Diagnosis:

Skin, left thigh, biopsy:Skin, left thigh, biopsy:

- Eccrine spiradenoma- Eccrine spiradenoma

Eccrine spiradenomaEccrine spiradenoma

Clinical:Clinical: Painful, solitary dermal tumor in the skin of upper half of Painful, solitary dermal tumor in the skin of upper half of

the body during 2the body during 2ndnd to 4 to 4thth decade. decade. Multiple tumors may be part of Brooke-Spiegler Multiple tumors may be part of Brooke-Spiegler

syndrome.syndrome.

Pathology:Pathology: Well-circumscribed or encapsulated dermal nodule Well-circumscribed or encapsulated dermal nodule

composed of small dark basaloid and large pale composed of small dark basaloid and large pale epithelial cells within a vascular stroma.epithelial cells within a vascular stroma.

Low-power view resembles a lymph node.Low-power view resembles a lymph node. Stroma contains appreciable number of lymphocytes.Stroma contains appreciable number of lymphocytes. Cuboidal epithelial cells form compacted cords with Cuboidal epithelial cells form compacted cords with

occasional ductal lumen formation with eosinophilic occasional ductal lumen formation with eosinophilic cuticle.cuticle.

Hyalinized matrix around the epithelial cords may Hyalinized matrix around the epithelial cords may resemble that of cylindroma.resemble that of cylindroma.