Assuntos
Adenoma de Glândula Sudorípara/diagnóstico , Neoplasias das Glândulas Sudoríparas/diagnóstico , Adenoma de Glândula Sudorípara/irrigação sanguínea , Adenoma de Glândula Sudorípara/patologia , Braço , Diagnóstico Diferencial , Feminino , Humanos , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/irrigação sanguínea , Neoplasias das Glândulas Sudoríparas/patologia , Neoplasias Vasculares/diagnósticoAssuntos
Adenoma de Glândula Sudorípara/patologia , Dermoscopia , Neoplasias de Cabeça e Pescoço/patologia , Couro Cabeludo/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma de Glândula Sudorípara/irrigação sanguínea , Biópsia , Carcinoma Basocelular/diagnóstico , Diagnóstico Diferencial , Neoplasias de Cabeça e Pescoço/irrigação sanguínea , Humanos , Masculino , Pessoa de Meia-Idade , Neovascularização Patológica/patologia , Couro Cabeludo/irrigação sanguínea , Neoplasias das Glândulas Sudoríparas/irrigação sanguíneaRESUMO
Eccrine spiradenoma (ES) usually occurs as a solitary small nodule. It presents rarely as multifocal or multiple localized tumors arranged in a linear, zosteriform or nevoid distribution. We present a rare case of a 55-year-old woman who had a 48-year history of multiple vascular eccrine spiradenomas (VES) localized on the left side of the submandibular region and neck. All five tumors were skin-colored or pinkish-purple, and ranged in size 1.5-2.5 cm. Histologically, each tumor was composed of two characteristic cell types and many dilated vascular spaces were noted in the stroma. Contrast-enhanced computed tomography showed irregularly shaped, enhanced areas at the center of the tumors. A published work search revealed 35 cases of multiple ES, but multiple VES was extremely rare. We summarized the features of previously reported multiple ES and discuss the clinical and histological classification of ES.
Assuntos
Adenoma de Glândula Sudorípara/patologia , Neoplasias Primárias Múltiplas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma de Glândula Sudorípara/irrigação sanguínea , Diagnóstico Diferencial , Glândulas Écrinas/irrigação sanguínea , Glândulas Écrinas/patologia , Feminino , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Pessoa de Meia-Idade , Neoplasias Primárias Múltiplas/irrigação sanguínea , Neoplasias das Glândulas Sudoríparas/irrigação sanguínea , Tomografia Computadorizada por Raios X/métodosAssuntos
Adenoma de Glândula Sudorípara/diagnóstico por imagem , Braço/diagnóstico por imagem , Neoplasias das Glândulas Sudoríparas/diagnóstico por imagem , Ultrassonografia Doppler em Cores , Adenoma de Glândula Sudorípara/irrigação sanguínea , Adulto , Células Epiteliais/patologia , Feminino , Humanos , Linfócitos/patologia , Gordura Subcutânea/diagnóstico por imagem , Gordura Subcutânea/patologia , Neoplasias das Glândulas Sudoríparas/irrigação sanguíneaRESUMO
We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.
Assuntos
Adenoma de Glândula Sudorípara/patologia , Glândulas Écrinas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Actinas/análise , Adenoma de Glândula Sudorípara/irrigação sanguínea , Adenoma de Glândula Sudorípara/metabolismo , Biomarcadores/análise , Glândulas Écrinas/irrigação sanguínea , Glândulas Écrinas/química , Feminino , Humanos , Imuno-Histoquímica , Queratina-7 , Queratinas/análise , Coreia (Geográfico) , Proteínas de Membrana/análise , Pessoa de Meia-Idade , Mucina-1/análise , Músculo Liso/química , Neoplasias das Glândulas Sudoríparas/irrigação sanguínea , Neoplasias das Glândulas Sudoríparas/metabolismoRESUMO
We report a rare case of giant vascular eccrine spiradenoma (GVES) which developed in 56-yr-old Korean woman. It is a rare variant of eccrine spiradenoma (ES), which might be mistaken for angiomatous lesions in view of its florid vascularity and hemorrhagic features. Histogenesis of GVES is not clearly elucidated although it is known that ES presumably originates in the eccrine glands. To clarify the histogenesis of GVES, immunohistochemical stainings using various monoclonal antibodies were also performed. The tumor was composed of three types of cells, namely pale epithelial cells, small basal cells, and myoepithelial cells. Therefore, we conclude that GVES originated from eccrine gland and mainly differentiates toward secretory portion of secretory coil.
Assuntos
Feminino , Humanos , Pessoa de Meia-Idade , Actinas/análise , Adenoma de Glândula Sudorípara/irrigação sanguínea , Biomarcadores/análise , Mucina-1/análise , Glândulas Écrinas/irrigação sanguínea , Imuno-Histoquímica , Queratinas/análise , Coreia (Geográfico) , Proteínas de Membrana/análise , Músculo Liso/química , Neoplasias das Glândulas Sudoríparas/irrigação sanguíneaRESUMO
Successful reconstructive surgery with muscle flaps depends on adequate arterial supply and undisturbed venous drainage. Combining such surgery with reconstructive vascular surgery of a large-caliber vein that is responsible for the venous drainage of the flap poses an additional challenge--the repaired vein's susceptibility to thrombosis. Every attempt must be made to prevent venous outflow obstruction following muscle flap surgery. Data from the vascular surgery literature demonstrate a low success rate for subclavian vein repair. The success rate with venous reconstructive surgery has been greater when a distal arteriovenous fistula accompanied the repair. The present case described the use of a temporary distal cephalic-brachial arteriovenous fistula to maintain the patency of the venous drainage of a pedicled latissimus dorsi muscle flap, following subclavian vein repair, for one-stage coverage of a large chest wall defect.
Assuntos
Adenoma de Glândula Sudorípara/cirurgia , Derivação Arteriovenosa Cirúrgica , Neoplasias Cutâneas/cirurgia , Veia Subclávia/cirurgia , Retalhos Cirúrgicos/irrigação sanguínea , Neoplasias Torácicas/cirurgia , Grau de Desobstrução Vascular/fisiologia , Adenoma de Glândula Sudorípara/irrigação sanguínea , Veia Axilar/cirurgia , Artéria Braquial/cirurgia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Cutâneas/irrigação sanguínea , Neoplasias Torácicas/irrigação sanguíneaRESUMO
A 60-year-old man suffering from cardiac insufficiency consulted the Dermatology Department, Inönü University Turgut Ozal Medical Center, because of a bleeding tumor on his right hypochondrium. The tumor had begun as a small nodule approximately 5 years before, and had grown slowly with time. A small, superficial ulcer had appeared on the lesion approximately 6 months previously, and slight bleeding had occasionally occurred. The patient had no pain and no other complaint except bleeding. Dermatologic examination revealed a violaceous, ulcerated, and bleeding tumoral lesion below the mid-portion of the right costochondral line. The tumor was a non-tender, hemispheric mass, approximately 3-4 cm in size, adherent to the epidermis, but movable on the underlying tissue. An incisional biopsy was performed with diagnoses of dermatofibrosarcoma protuberans and desmoid tumor. Histopathologic examination revealed prominent blood-filled vascular spaces and clearly delimited cords, showing two types of cell. The vascular spaces contained a periodic acid-Schiff (PAS)-positive, granular, eosinophilic material. There was no malignant transformation. The lesion was totally excised and primarily sutured.
Assuntos
Adenoma de Glândula Sudorípara/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma de Glândula Sudorípara/irrigação sanguínea , Adulto , Humanos , Masculino , Neoplasias das Glândulas Sudoríparas/irrigação sanguíneaRESUMO
Perivascular spaces were found to represent a useful histological clue to the diagnosis of eccrine spiradenoma. They were observed in eight of nine eccrine spiradenomas but not in syringomas, nodular basal cell carcinomas, or glomangiomas. Perivascular spaces in spiradenomas consisted of variably sized spaces around one or more central blood vessels, bordered at the periphery by a palisade of tumor cells and lined at both sides by basement membrane collagen type IV. Perivascular spaces contained variable numbers of T lymphocytes in all cases and could undergo fibrosis, cystic dilatation, or hyalinization. In analogy to similar structures in thymomas, we suggest that perivascular spaces in spiradenomas are involved in the traffic of lymphocytes toward the tumor.
Assuntos
Adenoma de Glândula Sudorípara/irrigação sanguínea , Vasos Sanguíneos/patologia , Neoplasias das Glândulas Sudoríparas/irrigação sanguínea , Adenoma de Glândula Sudorípara/patologia , Membrana Basal/patologia , Carcinoma Adenoide Cístico/irrigação sanguínea , Carcinoma Basocelular/irrigação sanguínea , Colágeno , Cistos/patologia , Diagnóstico Diferencial , Dilatação Patológica/patologia , Fibrose , Tumor Glômico/irrigação sanguínea , Humanos , Hialina , Neoplasias das Glândulas Sudoríparas/patologia , Siringoma/irrigação sanguínea , Linfócitos T/patologia , Timoma/irrigação sanguíneaRESUMO
Giant vascular eccrine spiradenoma (GVES) is a rare variant of benign tumors of the sweat glands, which differs from common eccrine spiradenoma in both its size and vascularity. Clinically as well as macroscopically, this intradermal or subcutaneous encapsulated tumor might be mistaken for an angiomatous lesion or thrombosis. Histological examination reveals clearly delimited "cords" showing two types of cells, prominent blood-filled cavities and extensive hemorrhages. According to immunohistochemical findings, the epithelial cells contain cytokeratin, protein S-100 and carcino-embryonal antigen (CEA). Like the endothelial cells of vessels, some of the luminal epithelial cells also bind Ulex europaeus lectin; however, they do not show factor VIII-associated antigen.
Assuntos
Adenoma de Glândula Sudorípara/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Adenoma de Glândula Sudorípara/irrigação sanguínea , Endotélio Vascular/patologia , Feminino , Humanos , Técnicas Imunoenzimáticas , Pessoa de Meia-Idade , Neoplasias das Glândulas Sudoríparas/irrigação sanguínea , Glândulas Sudoríparas/patologiaRESUMO
Two examples of a variant of benign spiradenoma are reported, both characterized by their large size and high degree of vascularity. The results of studies using light microscopy, transmission electron microscopy and immunohistology are described. The relationship of this unusual variant to other spiradenomas and their eccrine sweat gland origin is discussed. The possible misdiagnosis of this rare type of spiradenoma is emphasized.