221References 1 Velanovich V. Ectopic breast tissue, supernumerary breasts, and supernumerary nipples. South Med J 1995; 88: 903-906. 2 Evans DM, Guyton DP. Carcinoma of the axillary breast. J Surg Oncol 1995; 59: 190-195. 3 Routiot T, Marchal C, Verhaeghe JL et al. Breast carcinoma located in ectopic breast tissue: a case report and review of the literature. Oncol Rep 1998; 5: 413-417. 4 Pfeifer JD, Barr RJ, Wick MR. Ectopic breast tissue and breast-like sweat gland metaplasias: an overlapping spectrum of lesions. J Cutan Pathol 1999; 26: 190-196. 5 Wallace ML, Longacre TA, Smoller BR. Estrogen and progesterone receptors and anti-gross cystic disease fluid protein 15 (BRST-2) fail to distinguish metastatic breast carcinoma from eccrine neoplasms. Mod Pathol 1995; 8: 897-901. 6 Lukowsky A, Muche JM, Sterry W et al. Detection of expanded T cell clones in skin biopsy samples of patients with lichen sclerosus et atrophicus by T-cell receptor-gamma polymerase chain reaction assays. J Invest Dermatol 2000; 115: 254-259. 7 Kao GF, Graham JH, Helwig EB. Paget's disease of the ectopic breast with an underlying intraductal carcinoma: report of a case. J Cutan Pathol 1986; 13: 59-66. 8 Roorda AK, Hansen JP, Rider JA et al. Ectopic breast cancer: special treatment considerations in the postmenopausal patient. Breast J 2002; 8: 286-289. 9 Busam KJ, Tan LK, Granter SR et al. Epidermal growth factor, estrogen, and progesterone receptor expression in primary sweat gland carcinomas and primary and metastatic mammary carcinomas. Mod Pathol 1999; 12: 786-793. 10 Kaptain S, Tan LK, Chen B. Her-2/neu and breast cancer. Diagn Mol Pathol 2001; 10: 139-152. 11 Wick MR, Ockner DM, Mills SE et al. Homologous carcinomas of the breasts, skin, and salivary glands. A histologic and immunohistochemical comparison of ductal mammary carcinoma, ductal sweat gland carcinoma, and salivary duct carcinoma.whereas other parts of the tattoo remained unaffected. This indicates that viral inoculation probably took place during the second session, although the transmission of poxvirus could have been either via fomites, or contamination of the ink used for tattooing.

type VIN were strongly reactive to p16INK4 with a mean score of 5.5 (range 4-6, median ¼ 6), supporting their association with HPV ( Figure 1D).It is now generally accepted that there are at least two type of vulvar intraepithelial neoplasia (VIN): classic type VIN and simplex type VIN. Classic VIN is associated with HPV infection. 8 Currently, it is believed that simplex VIN is rarely associated with HPV infection. 4 In simplex VIN, p53 positive cells are often present above the basal cell layer whereas in classic VIN this does not occur. 4 Simplex VIN is also more frequently associated with well differentiated invasive squamous cell carcinoma.All of our classic VIN cases are strongly immunopositive with p16INK4 whereas 90% of our simplex VIN cases showed no reactivity to p16INK4 antibody. The remaining two cases exhibited focal weak positivity which may be considered negative in clinical practice, so that all of our classic VIN are positive and 100% of our simplex VIN are negative for p16INK4. Our study suggests that the immunohistochemical staining pattern of simplex VIN could thus be characterized as p16INK4 negative with p53 positive cells above the basal layer of the epidermis whereas classic warty type VIN is p16INK4 positive but negative for p53 in the supra-basilar layers.Our results affirm the current supposition that simplex VIN is usually a non-HPV-related lesion. Because of the higher rate of conventional invasive squamous cell carcinoma associated with simplex VIN, our findings support the premise that simplex VIN serves as a precursor to non-HPV-related invasive well differentiated squamous cell carcinoma of the vulva.

Background of study Steatocystoma multiplex (SM) and eruptive vellus hair cyst (EVHC), are both entities with similar clinical features, but with important histological differences. In the last few years, several authors have reported examples of both cysts with mixed histoiogical features, and have proposed the idea that the two conditions are related.Subjects We report here 3 cases, histological features of SM, EVHC. and the other presenting cysts with mixed histological findings.Conclusions The different histological findings in the cases reported support the idea that SM and EVHC are extremes of a spectrum

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