Solitary Cylindroma (Dermal Analog Tumor) of the Breast

Abstract

The authors report a previously undescribed small, well-demarcated breast tumor similar to a dermal cylindroma in a 63-year-old woman. The tumor was an incidental finding in a lumpectomy specimen for infiltrating lobular carcinoma. The cylindroma was surrounded by normal-appearing breast parenchyma and had the typical "jigsaw" pattern of epithelial basaloid islands. The islands showed focal squamous and myoepithelial differentiation. A notable number of reactive dendritic Langerhans cells permeated the epithelial cell islands, a feature considered to be characteristic of dermal cylindroma. There was also ductal differentiation. Thick bands of hyaline periodic acid-Schiff (PAS) stain and collagen IV-positive basement membrane material bordered the cell islands, and PAS-collagen IV-positive hyaline globules were seen within the cell islands. There was no nuclear pleomorphism or mitotic figures. The cylindroma did not express gross cystic disease fluid protein 15, carcinoembryonic antigen, estrogen and progesterone receptors, or cytokeratin 20 (CK20). There was diffuse and strong immunoreactivity to CK AE1/AE3, and focal reactivity for CK7 and smooth muscle actin. Cylindroma of the breast should be distinguished from adenoid cystic carcinoma and basal cell carcinoma. Although clearly epithelial, the exact histogenesis and cell phenotype of this unusual dermal type cylindroma of the breast are unknown.

Breast Neoplasms with Dermal Analogue Differentiation (Mammary Cylindroma): Report of 3 Cases and a Proposal for a New Terminology

“…Immunohistochemistry was similar to that reported previously [1,2,3,4,5] and to case 1. In addition, there were cells at the edge of some nests that were positive for smooth muscle actin and smooth muscle myosin, whereas other nests showed no staining.…”

“…Dermal cylindroma is a well-recognised benign eccrine skin tumour. Tumours with similar morphology have been identified within the breast (table 1) [1,6,7,8,9], kidney [10], lung [5] and salivary glands [11]. All these organs share ductal and basal/myoepithelial structures supporting the proposal that cylindroma results from an aberration of ductal differentiation [9].…”

“…Both lesions have nodular and trabecular growth patterns with basement membrane-like material around the islands of tumour cells. Both can have an irregular edge, but previous reports of mammary cylindroma have used the term ‘pseudo-infiltration' [1,6,9]. Furthermore, the presence of cells demonstrating the immune profile of myoepithelial/basaloid cells admixed with cells exhibiting a luminal immune profile and the presence of tubular/ductal structures are seen within both tumours.…”

“…Mammary cylindroma, a rare entity first described in 2001, can be diagnostically challenging [1]. To date, only 14 cases have been reported in the literature.…”

Fine Needle Aspiration Cytology of Breast Cylindroma in a Woman with Familial Cylindromatosis

“…This occurrence is to be expected as breast tissue arises from the same anlage that gives rise to cutaneous sweat glands. 1 Sweat gland-type tumors that have been reported to occur in the breast include benign mixed tumor, 2,3 syringoma 4,5 and eccrine poroma. 6 Gokaslan et al published the first report of a primary breast tumor similar to a cutaneous cylindroma that was an incidental finding in a patient with breast carcinoma.…”