Eccrine sweat gland carcinoma: an histologic and immunohistochemical study of 32 cases^*

Abstract

In an attempt to characterize the immunocytochemical attributes of eccrine sweat gland carcinoma, we studied 32 examples of this tumor with antibodies to epithelial membrane antigen (EMA), cytokeratin (CK), carcinoembryonic antigen, S100 protein, alpha-lactalbumin, salivary amylase, blood group isoantigens, beta-2-microglobulin, and Leu M1. All cases expressed EMA and CK, and 28 of 32 cases also displayed at least 2 of the 6 remaining antigens. No significant variations were noted in the immunophenotypes of histologic subtypes of eccrine carcinoma. These results provide an objective means of diagnostic separation between sweat gland carcinoma and other primary malignant cutaneous tumors. However, they do not appear to correlate with the degree of tumoral differentiation, and are of no assistance in the separation of benign and malignant sudoriferous neoplasms. The ability of immunocytochemical techniques to distinguish between primary malignant adnexal cutaneous tumors and metastases to the skin appears unlikely, but remains to be studied further. Also, the use of immunostaining panels is advised in the study of adnexal carcinomas, since no single determinant in isolation is specific for these neoplasms.

Microcystic adnexal carcinoma: an immunohistochemical reappraisal

“…12,14,17,[38][39][40][41] In our study, while expression of CK15 in the majority of cases of microcystic adnexal carcinoma argues in favor of pilar differentiation, luminal ductal staining with CK7, CD15 and CEA is suggestive of sweat gland differentiation. Ultrastructural studies confirm this dual pilar and sweat gland differentiation.…”

“…However, studies investigating the utility of immunohistochemistry in the diagnosis of microcystic adnexal carcinoma are few and restricted both in the spectrum of lesions and antibodies studied (Table 1). [12][13][14][15][16][17][18][19][20][21][22][23][24][25][26] Thus, even though immunohistochemical comparisons of microcystic adnexal carcinoma vs infiltrative basal cell carcinoma and desmoplastic trichoepithelioma exist in the published literature, they are confined to a single stain; and to date, only two studies employing a panel of immunohistochemical stains are performed. 17,19,21,23,24,26 In addition, a comparative study of microcystic adnexal carcinoma with squamous cell carcinoma particularly squamous cell carcinoma with ductal differentiation has not, to our knowledge, been reported previously.…”

Malignant adnexal neoplasms

“…The neoplasm is divergent morphologically from the typical eccrine spiradenoma or eccrine acrospiroma and other allied benign eccrine adnexal neoplasms by virtue of showing a papillary or micropapillary architecture cognate to that of insitu papillary carcinomas of ductal structures of the human breast. 186,[188][189][190][191][192][193][194][195][196] In particular, these neoplasms tend to manifest areas of micropapillary projections protruding into cystically dilated luminal spaces; these micropapillary structures lack fibrovascular cores. The micropapillae comprise tufts of banal or variably atypical low columnar epithelium, sometimes showing apocrine differentiation.…”

“…Some forms show a fibromyxoid stroma, which has caused some authorities to label such lesions malignant chondroid syringoma, 189,272 while others use the term eccrine adenocarcinoma with fibromyxoid stroma. 189,272 These lesions may connect to the epidermal surface and so mimic forms of basal cell or squamous cell carcinoma with myxoid stroma, but invariably express EMA, enabling distinction. 189,278 These tumors may collide with other forms of primary eccrine cancer.…”

“…189,272 These lesions may connect to the epidermal surface and so mimic forms of basal cell or squamous cell carcinoma with myxoid stroma, but invariably express EMA, enabling distinction. 189,278 These tumors may collide with other forms of primary eccrine cancer.…”