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Ekkrinny spiradenoma

Ekkrinny spiradenoma — the benign tumor of a sweat gland, a gistogeneticheska connected with a vnutridermalny channel.

Epidemiology

Quite rare tumor which arises at persons of middle and young age more often (till 40 flyings — 72% of cases, at children till 10 flyings is 10,8% of cases), approximately in an equal ratio at men and women.

Classification

Allocate 6 histologic options of a tumor:
• solid;
• tubular;
• ferruterous;
• tsilindromatozny;
• angiomatous;
• mixed.

Etiology and pathogeny

Are studied a little.

Clinical signs and symptoms of an ekkrinny spiradenoma

Localization of a tumor universal, mainly on skin of upper parts of a trunk, the head, except for skin of palms, a nail bed, an areola of a nipple, vulvar lips, a prepuce. Solitary educations prevail.
The tumor can arise in the form of the intradermal node towering over the level of surrounding skin. The surface over the acting node can be not changed or to get a brownish shade. Other clinical option is possible in the form of an exophytic node of a hemispherical form on the wide basis with smooth or slightly hilly surface of pinkish color or a node on narrower basis with a translucent wall of a light gray or bluish shade. The weak or moderately expressed sensitivity of a tumor to tactile or temperature influences is noted. Morbidity can spontaneously appear in the form of short-term attacks. About 5% of tumors ulcerate and bleed. Rare option of this tumor is the multiple zosteriformny ekkrinny spiradenoma.

The diagnosis and the recommended clinical trials

Cytologic research of a smear-skarifikata or punctate, and also biopsy are shown.
The Ekkrinny spiradenoma is characterized by the multiple encapsulated small knots in a derma consisting of 2 main types of cells — larger with light puzyrkovidny kernels and moderately basphilic cytoplasm, so-called light cells, and small, with scanty cytoplasm and hyperchromic kernels — "dark" cells. The last hold in relation to the first peripheral position, forming palisadoobrazny structures. "Dark" and "light" cells can be located in nodes without any orientation or create structures in a look tubul which central part was made by "light" cells and on the periphery in one row "dark" cells are located.
Existence of the unripe vessels of sinusoidny type filled with blood or chyliform liquid is pathognomonic.
In a tumor there are 2 types of cells: undifferentiated bazalioidny cells with small dark kernels and the differentiated cells with large light kernels. The majority of the differentiated cells unripe. In most cases pro-current structures which internal surface is covered with the short, densely located microvillis (a sign of a vnutridermalny pro-current differentiation) prevail. Around gleams some cells have a large number of microvillis and well developed tonofilaments. The signs inherent to secretory department of a sweat gland in the form of "mucous" and myoepithelial cells, as a rule, are absent. "Hyaline" membranes around and in tumoral small knots at tsilindromatozny option of a spiradenoma consist of the geared-up basal membrane.

Differential diagnosis

Glomusangioma, tumors from covers of peripheral nerves, an ekkrinny akrospiroma.

General principles of treatment

Surgical excision, electroexcision, laser evaporation.

Forecast

Favorable.
 
"Ekkrinny ferry   Extramammary illness of Pedzhet"