On‐site cytological diagnosis of cylindroma: A case report

Abstract

A 70-year-old female presented with a swelling in the right auricle for 6 months. Rapid onsite stain and routine cytology revealed clusters of small, round to oval cells with hyperchromatic nuclei, inconspicuous nucleoli, and scant cytoplasm. The background had basement membrane type material and appeared dark magenta colored pinkish globular material. Hence a cytological diagnosis of skin adnexal tumor possibly cylindroma was made. The excision of the lesion also showed features of cylindroma. Rapid onsite staining and cytology of subcutaneous location of the tumor in the absence of primary salivary gland tumors may help to diagnose such rare cases. K E Y W O R D S cylindroma, cytology, histopathology, rapid onsite, toluidine blue 1 | BACKGROUND Cylindroma is a benign skin adnexal neoplasms of eccrine or apocrine origin. They most commonly occur on the head and neck as solitary or multiple tumors. 1 When multiple cylindromas occur on the scalp, they can grow together and resemble a hat or turban, giving rise to the previously more common term "turban tumor". 2 FNAC is a minimally invasive technique along with the use of rapid stain is an adjunct for sample adequacy and provisional diagnosis. 3 We report the cytological findings with an on-site correlation of such adnexal lesion. 2 | CASE PRESENTATION A 70-year-old female presented with swelling in right auricular swelling for the last 1 year. She had no other swelling in other parts of the body. On examination a well-defined painless lesion measuring 1.5 × 1.5 cm.

Cutaneous eccrine spiradenoma: Insights into cytomorphological features via fine needle aspiration biopsy and a comprehensive literature review

“…Cylindroma, another benign adnexal tumour may mimic ES on cytology specimens and share similar immunohistochemical staining pattern. 21 While ES may exhibit metachromatic-stained hyaline globules or stromal material in the background with prominent lymphocytes, 22 cytology of cylindroma is characterized by the presence of clusters of small round to oval basaloid cells with hyperchromatic nuclei attached to abundant magenta coloured acellular hyaline material and lack of T lymphocytes. 23 Cell clusters of cylindromas often display nested pattern with jigsaw puzzle arrangement.…”

“…28 Molecular studies aid in differentiating ES from other adnexal tumours that may share certain cytomorphologic features and immunohistochemical staining patterns such as cylindromas and ACCs. 21,29 While ES acquire ALPK1 (alpha kinase 1) gene mutations in 43% of cases and occasional CYLD gene inactivation in approximately 29% of cases; cylindromas tend to acquire CYLD gene inactivation in nearly 100% of cases. 29,30 In the other hand, ACC acquires MYB::NFIB fusion in 73-83% of cases and MYBL1::NFIB fusion in 20-23% of cases.…”