Breast - nonmalignant
Benign tumors / changes
Cylindroma (dermal type)

Author: Monika Roychowdhury, M.D., FCAP (see Authors page)

Revised: 4 August 2017, last major update February 2017

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Cylindroma [title] breast
Cite this page: Cylindroma (dermal type). PathologyOutlines.com website. http://pathologyoutlines.com/topic/breastcylindroma.html. Accessed November 18th, 2017.
Definition / general
Essential features
  • Benign skin adnexal tumor, rarely can arise in breast
  • Histologically identical to dermal counterpart, with nests and trabeculae of cells in a "jigsaw" puzzle pattern
  • Nests show peripheral myoepithelial cells (p63+), central basaloid cells (CK7+), duct-like lumina with or without secretions and are peripherally lined by thick basement membrane material (PASD+ and collagen IV+)
  • Important to differentiate from adenoid cystic carcinoma
Terminology
  • Also called dermal analog tumor
  • "Cylindroma" was first used by Billroth in 1959 (Int J Trichology 2013;5:83), based on nests of cells surrounded by hyaline, resemble a cylinder in cross section
  • Cylindroma of the breast was first described in 2001 by Gokaslan (Am J Surg Pathol 2001;25:823)
Epidemiology
  • May be associated with turban tumor syndrome (Brooke-Spiegler syndrome, OMIM: Brooke-Spiegler Syndrome; BRSS)
  • Brooke-Spiegler syndrome is characterized by multiple skin appendage tumors such as cylindromas, trichoepitheliomas and spiradenomas; the gene responsible for multiple cylindromas, CYLD, is localized to band 16q12-q13
Pathophysiology
  • Exact cellular origin unknown; most likely a very primitive sweat gland tumor differentiating towards apocrine line
Radiology images

Images hosted on other servers:

Screening mammogram

Ultrasound screening

Case reports
Treatment
  • Excision
Clinical images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick

Gross description
Microscopic (histologic) description
  • Jigsaw pattern of epithelial basaloid islands with focal squamous and myoepithelial differentiation
  • Islands are bordered by thickened basement membrane, contain hyaline globules
  • Also reactive dendritic Langerhans cells that permeate islands, clusters of sebaceous cells and a few eccrine ducts
  • No nuclear pleomorphism, no mitotic figures
Microscopic (histologic) images

Images hosted on PathOut server:

Contributed by Dr. Mark R. Wick



Images hosted on other servers:

Basaloid cells in jigsaw puzzle pattern

Jigsaw appearance with nests of basaloid cells surrounded by dense hyaline basement membrane

CK7 highlights central larger cells

p63 highlights peripheral cells


Dermal cylindroma

Skin

PAS, skin

Cytology description
  • Small uniform cells with finely granular cytoplasm and oval nuclei
  • Some cells are arranged around cylinders of dense acellular material, resembles adenoid cystic carcinoma (Acta Cytol 2004;48:853)
Positive stains
Negative stains
Differential diagnosis
Additional references