ADNEXAL TUMORS

Question 1

Answer 1

Question 2

POROID CELLS + EPIDERMAL ATTACHEMENT

Answer 2

Poroma

Question 3

POROID CELLS + INTRAEPIDERMAL

Answer 3

HIDROACANTHOMA SIMPLEX

Question 4

POROID CELLS + SMALL DERMAL NODULES

Answer 4

DERMAL DUCT TUMOR

Question 5

POROID CELLS + LARGE DERMAL NODULE +/- CYSTS

Answer 5

HIDRADENOMA

Question 6

Answer 6

Question 7

TADPOLE-SHAPED DUCTS

Answer 7

Derived from the eccrine gland ducts

Question 8

CYST + DECAPITATION SECRETION

Answer 8

APOCRINE HIDROCYSTOMA

Question 9

Answer 9

APOCRINE HIDROCYSTOMA

Question 10

CYST + 2 LAYERS OF CUBOIDAL CELLS + NO DECAPITATION SECRETION

Answer 10

Question 11

• Opens to surface
• Blue papillary fronds projecting into lumen (clear space)
• Decapitation secretion
• Plasma cells

Answer 11

Question 12

• BLUE dermal nodule with branching cystic spaces
• Papillary fronds projecting into lumen
• Decapitation secretion

Answer 12

Question 13

Difference of SYRINGOCYSTADENOMA PAPILLIFERUM from HIDRADENOMA PAPILLIFERUM

Answer 13

SCAP looks like a SLIDE (invagination looks like a playground slide) while HP is maze-like and plasma cells are not seen

Question 14

JIGSAW PUZZLE

Answer 14

Question 15

BLUE BALL + PEPPERED BY LYMPHOCYTES

Answer 15

Question 16

Question 17

Answer 17

Question 18

stains for Sialomucin (EMPD)

Answer 18

Alcian blue (pH2.5), Colloidal iron, Mucicarmine, PAS

Question 19

What is the staining of EXTRAMAMMARY PAGET’S DISEASE for PAS and diastase

Answer 19

• Diastase resistant means they don’t contain any glycogen to be digested by diastase

Question 20

Stains for EMPD

Answer 20

CAM5.2, EMA, CK7

Question 21

staining pattern of Primary EMPD

Answer 21

CK 7 (+), CK 20 (-)

Question 22

Secondary EMPD staining pattern

Answer 22

CK 7 (-), CK 20 (+)

Question 23

SEBACEOUS GLAND STAINS

Answer 23

Question 24

LARGE SEBACEOUS GLANDS AROUND A DILATED FOLLICLE

Answer 24

Question 25

BUMPY (papillomatosis), BALD (loss of hair follicles), BUBBLY (high-lying sebaceous glands), BIG GLANDS (apocrine)

Answer 25

Question 26

1. Diagnosis 2. Associated syndrome 3. Associated visceral malignancy with syndrome

Answer 26

1. Sebaceous Adenoma 2. Muir-Torre Syndrome 3. Colon and endometrial cancer * Increase in basaloid germinative cells * Sebaceous glands > basaloid cells (<50% basaloid cells)

Question 27

Organoid tumor - comprises of abnormality in the epidermis, hair follicles, sebaceous glands and sweat glands

Answer 27

Nevus Sebaceus

Question 28

* Increase in basaloid germinative cells * Sebaceous glands > basaloid cells (<50% basaloid cells)

Answer 28

Question 29

Question 30

1. diagnosis 2. Associated syndromes 3. Gene mutation

Answer 30

1. CYLINDROMA 2. Brooke-Spiegler Syndrome and Multiple Familial Trichoepitheliomas 3. CLYD1 ## Footnote - basaloid islands in a jigsaw pattern made up of 2 cell population (pale cells in the center and dark cells at the periphery) with hyaline droplets in the middle of the lobules

Question 31

Answer 31

- poroid cells in the epidermis which grows down into the epidermis with an epidermal attachment POROMA

Question 32

Answer 32

- lobule with a predominance of basaloid germinative cells and pockets of sebocytes SEBACEOMA

Question 33

1. diagnosis 2. typical location

Answer 33

1. SYRINGOCYSTADENOMA PAPILLIFERUM 2. Scalp - papillae covered by 2 layers of cells and inner columnar cell layer with decapitation secretion and an outer myoepithelial layer - papillae has fibrovascular core lots of PLASMA CELLS ## Footnote Inner layer: columnar to cuboidal epithelium with decapitation secretion; (+) CK7, EMA and CEA Outer layer: basal/ myoepithelial cells; (+) SMA

Question 34

1. Diagnosis 2. Associated syndrome 3. Positive immunohistochemical stains

Answer 34

1. Apocrine hidrocystoma 2. Schöpf-Schulz Passarge syndrome and Goltz-Gorlin syndrome 3. (+) HMFG-1 and GCDFP (eccrine hidrocystoma is negative for these markers) ## Footnote Cyst + decapitation secretion

Question 35

1. diagnosis 2. differentiation 3. associated syndrome

Answer 35

1. Syringoma 2. Eccrine ducts 3. Down syndrome

Question 36

Answer 36

SYRINGOCYSTADENOMA PAPILLIFERUM ## Footnote * papillae covered by 2 layers of cells and inner columnar cell layer with decapitation secretion and an outer myoepithelial layer * papillae has fibrovascular core lots of PLASMA CELLS * Inner layer: columnar to cuboidal epithelium with decapitation secretion; (+) CK7, EMA and CEA * Outer layer: basal/ myoepithelial cells; (+) SMA

Question 37

1. Diagnosis 2. typical location

Answer 37

1. Hidradenoma papilliferum 2. Anogenital region in females (typically located on the vulva)

Question 38

1. Diagnosis 2. typical location 3. differentiation

Answer 38

1. Hidradenoma papilliferum 2. Anogenital region in females (typically located on the vulva) 3. apocrine glands ## Footnote A, Hidradenoma papilliferum occurs as a well-circumscribed solid and cystic dermally based nodule, with interconnected glands that form labyrinthlike arrangements of tumor cells. B, The projections are composed of cuboidal and columnar epithelium with decapitation secretion and a basal layer of myoepithelial cells.

Question 39

Answer 39

A, **Adenoid cystic carcinoma** is composed of dermal islands of basaloid cells. B, The tumor cells have a **characteristic cribriform arrangement, with punched out pseudocysts filled with mucin. ** C, The tumor cells usually stain positively for CD117 (cKIT)

Question 40

1. Diagnosis 2. Differentiation 3. MC site

Answer 40

1. Trichofolliculoma 2. Panfollicular 3. Nose

Question 41

Identify the structure

Answer 41

Apocrine gland

Question 42

Identify the structure

Answer 42

Eccrine duct

Question 43

Identify the structure

Answer 43

Apocrine duct ## Footnote * 2 LAYERS OF CUBOIDAL EPITHELIUM * EOSINOPHILIC CUTICLE AROUND LUMEN * NO MYOEPITHELIAL CELLS

Question 44

SWEAT GLAND STAINS

Answer 44